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In this study, clinical database and blood sample bank of acute chest pain (ACP) will be established at chest pain center of multi-center hospital. To explore new biomarkers and screen clinical indicators with effective risk stratification and prognostic evaluation for ACP through proteomics technology and statistics methods. Risk stratification and short-term and long-term prognostic evaluation models for high-risk ACP will be established using large data analysis.
In this study, acute chest pain (ACP) patients will be selected from chest pain center of nine large tertiary hospitals in China from November 1, 2019 to October 31, 2021. All the selected patients will sign the informed consent.
Patients' characteristics, the first vital signs at the time of consultation, the first arterial blood gas, complete blood count, coagulation markers, blood biochemical results and myocardial injury markers, imaging examinations and electrocardiogram will be collected within 30 minutes at admission. Meanwhile, whole blood and plasma samples will be collected and stored in - 80 ℃ refrigerator. After diagnosis according to the gold standard examination or related guidelines, patients will be admitted to different department for standard treatment. Medication, surgical procedures and complications will be recorded carefully. Plasma and whole blood will be used to detect proteomics and/or genomics biomarkers associated with early evaluation of ACP.
Screening early evaluation indicators using novel protein biomarkers and easy-to-obtain clinical indicators, and establishing evaluation models for high-risk ACP by data analysis methods. Area under the receiver operating characteristic curves (AUROC), net reclassification improvement (NRI), integrated discrimination improvement (IDI) and decision curve analysis (DCA) will be used to evaluate the prediction ability of the model.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Acute chest pain | The population in this study are characterized by acute chest pain as the first symptom for consultation within 24 hours. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Coronary angiography | Diagnostic Test | Acute chest pain patients, suspected acute coronary syndrome, are diagnosed by coronary angiography. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Rate of participants with all-cause death | Patients die of all causes during hospitalization or follow-up | One year |
| Rate of participants with cardiovascular death | Patients die of cardiac and cerebrovascular diseases during hospitalization or follow-up | One year |
| Rate of participants with major adverse cardiac events (MACEs) | MACEs include cardiac death, stroke, and recurrent myocardial infarction. | One year |
| Rate of participants with acute myocardial infarction | Chest pain patients are diagnosed as acute myocardial infarction based on fourth edition of guidelines for myocardial infarction | Twenty-four hours |
| Rate of participants with acute pulmonary embolism | Chest pain patients are diagnosed as acute pulmonary embolism based on CT of pulmonary angiography. | Twenty-four hours |
| Rate of participants with acute aortic dissection | Chest pain patients are diagnosed as acute aortic dissection based on CT of aortic angiography. | Twenty-four hours |
| Rate of participants with acute coronary syndrome | Chest pain patients are diagnosed as acute coronary syndrome based on European Society of Cardiology (ESC) guidelines. | Twenty-four hours |
| Measure | Description | Time Frame |
|---|---|---|
| Rate of participants with ischemia or necrosis of lower limbs | Patients complicate with ischemia or necrosis of lower limbs during hospitalization | Two weeks |
| Rate of participants with acute heart failure |
| Measure | Description | Time Frame |
|---|---|---|
| Length of stay | Time between patient's visit and discharge | Two weeks |
| Rate of re-admitted participants | Re-admission after discharge within 6 months |
Inclusion Criteria:
Exclusion Criteria:
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The population in this study is characterized by acute chest pain as the first symptom for consultation. These are mainly Han and Tibetan patients from southwest China. The study population included first-visit and referral patients.
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Dongze Li, MBBS | Contact | +86-28-85422461 | dongze.li@ymail.com | |
| Yisong Cheng, MBBS | Contact | +86-19983154487 | yisongcheng01@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Dongze Li, MBBS | Emergency Department, West China Hospital, Sichuan University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Affiliated Hospital of Zunyi Medical University | Recruiting | Zunyi | Guizhou | 563000 | China |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 37050937 | Derived | Li F, Li D, Yu J, Jia Y, Wen J, Li W, Tong Y, Wu J, Wan Z, Cao Y, Zhang Q, Zeng R. Association Between Plasma Ceramides and One-Year Mortality in Patients with Acute Coronary Syndrome: Insight from the PEACP Study. Clin Interv Aging. 2023 Apr 6;18:571-584. doi: 10.2147/CIA.S402253. eCollection 2023. |
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This study will share individual participant data (IPD) including patient characteristics, vital signs, laboratory examinations, imaging examinations, diagnosis, adverse events in hospital and long-term prognosis.
Six months after completion of the test
IPD will be public accessable via Electronic Data Capture. (ResMan: http://www.medresman.org.)
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Whole blood and plasma
| CT angiography of aorta | Diagnostic Test | Acute chest pain patients, suspected acute aortic dissection, are diagnosed by gold standard of CTA. |
|
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| CT angiography of pulmonary arteries. | Diagnostic Test | Acute chest pain patients, suspected acute pulmonary embolism, are diagnosed by gold standard of CTA. |
|
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| Electrocardiogram | Diagnostic Test | All patients with acute chest pain will subject to ECG examination within 10 minutes of admission, which can quickly screen ST-segment elevation myocardial infarction. |
|
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| Cardiac Troponin | Diagnostic Test | Dynamic changes of cardiac troponin I and/or T will be used in the diagnosis of acute myocardial infarction |
|
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Patients complicate with acute heart failure during hospitalization
| Two weeks |
| Rate of participants with revascularization | Patients receive revascularization for recurrent angina or myocardial infarction during hospitalization | Two weeks |
| Rate of participants with consciousness disorder | Patients complicate with consciousness disorder during hospitalization | Two weeks |
| Rate of participants with cardiogenic shock | Patients complicate with cardiogenic shock during hospitalization | Two weeks |
| Rate of participants with acute kidney injury | Patients complicate with acute kidney injury during hospitalization | Two weeks |
| Rate of participants with malignant arrhythmia | Patients complicate with malignant arrhythmia during hospitalization | Two weeks |
| Rate of participants with pericardial tamponade | Patients complicate with pericardial tamponade during hospitalization | Two weeks |
| Rate of participants with bleeding | Patients complicate with bleeding | One year |
| Rate of participants with multiple organ dysfunction syndrome | Patients complicate with multiple organ dysfunction syndrome during hospitalization | Two weeks |
| Rate of participants with respiratory failure | Patients complicate with respiratory failure during hospitalization | Two weeks |
| Rate of participants with cardiac arrest | The sudden termination of cardiac ejection function, the disappearance of great artery pulsation and heart sound, and severe ischemia and hypoxia of important organs (such as brain) lead to the termination of life. | Two weeks |
| Six months |
| Chengdu Second People's Hospital | Recruiting | Chengdu | Sichuan | 610021 | China |
|
| Chengdu Shangjin Nanfu Hospital | Recruiting | Chengdu | Sichuan | 610041 | China |
|
| Sichuan Integrative Medicine Hospital | Recruiting | Chengdu | Sichuan | 610041 | China |
|
| West China Hospital, Sichuan University | Recruiting | Chengdu | Sichuan | 610041 | China |
|
| People's Hospital of Xindu District | Recruiting | Chengdu | Sichuan | 610500 | China |
|
| Affiliated Hospital of Southwest Medical University | Recruiting | Luzhou | Sichuan | 646099 | China |
|
| Panzhihua Central Hospital | Recruiting | Panzhihua | Sichuan | 617000 | China |
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| Zigong Fourth People's Hospital | Recruiting | Zigong | Sichuan | 643000 | China |
|
| ID | Term |
|---|---|
| D002637 | Chest Pain |
| D011655 | Pulmonary Embolism |
| D054058 | Acute Coronary Syndrome |
| ID | Term |
|---|---|
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D004617 | Embolism |
| D016769 | Embolism and Thrombosis |
| D014652 | Vascular Diseases |
| D002318 | Cardiovascular Diseases |
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
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| ID | Term |
|---|---|
| D017023 | Coronary Angiography |
| D004562 | Electrocardiography |
| ID | Term |
|---|---|
| D057791 | Cardiac Imaging Techniques |
| D003952 | Diagnostic Imaging |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D000792 | Angiography |
| D011859 | Radiography |
| D003935 | Diagnostic Techniques, Cardiovascular |
| D006334 | Heart Function Tests |
| D004568 | Electrodiagnosis |
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