Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Cardiovascular diseases are the leading cause of death worldwide. Among them, coronary artery disease-especially in its acute form, known as acute coronary syndrome (ACS)-is the most frequent cause of cardiovascular death. There are two main types of ACS: ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation ACS (NSTE-ACS). While the occurrence of serious heart rhythm and conduction disturbances is well established in STEMI, these complications are believed to be much less frequent in NSTE-ACS. However, their actual frequency in this population remains unclear due to limited studies, especially in emergency settings.
The main purpose of this study is to estimate the frequency of serious rhythm and conduction disorders in patients presenting with NSTE-ACS in emergency departments. The hypothesis is that these events are rare in this population and may not justify routine continuous cardiac monitoring for all such patients, as currently recommended.
Secondary objectives include identifying risk factors for these complications, estimating their frequency during hospitalization, assessing the frequency of minor rhythm and conduction disorders, evaluating care times and patient flow in emergency departments, and assessing patient outcomes up to 30 days-including hospitalizations, length of stay, discharge disposition, all-cause mortality, and the occurrence of five major adverse cardiovascular events (5-point MACE).
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Non-ST segment elevation ACS | 500 adult patients admitted to the emergency department and diagnosed with non-ST segment elevation ACS |
Not provided
| Measure | Description | Time Frame |
|---|---|---|
| Occurrence of Serious Rhythm or Conduction Disturbances in the Emergency Department | Occurrence of at least one serious rhythm or conduction disturbance during emergency department management, including: sustained ventricular tachycardia (VT), ventricular fibrillation (VF), torsades de pointes, high-degree conduction disorders (Mobitz type II AV block, third-degree AV block, trifascicular block), pulseless electrical activity (PEA), and asystole. | During emergency department stay, assessed up to 24 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of Non-Life-Threatening Arrhythmias or Conduction Disorders in the Emergency Department | Occurrence of arrhythmias not immediately life-threatening: atrial fibrillation or flutter, Mobitz type I AV block, first-degree AV block, sinus node dysfunction, or non-sustained VT | During emergency department stay, assessed up to 24 hours |
Not provided
Inclusion Criteria:
Exclusion Criteria:
Not provided
Not provided
Not provided
Adult patients admitted to the emergency department and diagnosed with non-ST segment elevation ACS
| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Sabrina GARNIER-KEPKA, Dr | Contact | +33369551335 | Sabrina.GARNIER-KEPKA@chru-strasbourg.fr | |
| Valérie WILME, Dr | Contact | +33388149731 | valerie.wilme@chru-strasbourg.fr |
| Name | Affiliation | Role |
|---|---|---|
| Sabrina GARNIER-KEPKA, Dr | Hôpitaux Universitaires de Strasbourg | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Centre Hospitalier de Haguenau | Haguenau | Bas-Rhin | 67091 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 33430516 | Background | Bouisset F, Ruidavets JB, Dallongeville J, Moitry M, Montaye M, Biasch K, Ferrieres J. Comparison of Short- and Long-Term Prognosis between ST-Elevation and Non-ST-Elevation Myocardial Infarction. J Clin Med. 2021 Jan 7;10(2):180. doi: 10.3390/jcm10020180. | |
| 19549010 | Background | Pines JM, Pollack CV Jr, Diercks DB, Chang AM, Shofer FS, Hollander JE. The association between emergency department crowding and adverse cardiovascular outcomes in patients with chest pain. Acad Emerg Med. 2009 Jul;16(7):617-25. doi: 10.1111/j.1553-2712.2009.00456.x. Epub 2009 Jun 22. |
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
Not provided
| Number of patients presenting complications prior to a confirmed diagnosis of NSTE-ACS |
Occurrence of complications such as syncope, presyncope, cardiogenic shock, respiratory distress, or rhythm/conduction disturbances before final diagnosis of NSTE-ACS. |
| Prior to establishing a confirmed diagnosis of NSTE-ACS in the ED, assessed up to 12 hours |
| Duration of Stay in the Emergency Department | Time spent in the emergency department and in the short-stay unit (UHCD) before transfer or discharge. | From ED admission to hospital admission, discharge, or UHCD discharge; up to 72 hours |
| Number of patients by disposition at emergency department discharge (home vs. hospital admission and type of admitting service | Disposition of patients: home discharge or hospital admission. For admitted patients, type of service recorded (ICU, coronary care unit, cardiology, internal medicine, short-stay unit, or other). | At the time of emergency department discharge or transfer, assessed up to 72 hours from ED admission |
| Duration of Hospitalization | Overall length of stay for hospitalized patients | From hospital admission to hospital discharge, assessed up to 14 days. |
| Number of patients with all-cause mortality or 5-point major adverse cardiovascular events (5P-MACE) at 30 days | This composite outcome includes the number of participants who experience either all-cause death or at least one of the following 5-point major adverse cardiovascular events (5P-MACE) within 30 days:
| Day 30 post-ED management |
| Clinical features : weight | Weight (kg) | From admission to discharge from hospital, assessed up to 7 days |
| Clinical features : height | Height (cm) | From admission to discharge from hospital, assessed up to 7 days |
| Clinical features : heart rate | Heart rate (bpm) | From admission to discharge from hospital, assessed up to 7 days |
| Clinical data : blood and arterial pressure | systolic/diastolic blood pressure (mmHg) and mean arterial pressure (mmHg) | From admission to discharge from hospital, assessed up to 7 days |
| Clinical data : oxygen saturation | peripheral capillary oxygen saturation (%) | From admission to discharge from hospital, assessed up to 7 days |
| Clinical data : temperature | Temperature (°C) | From admission to discharge from hospital, assessed up to 7 days |
| clinical data : capillary blood glucose | Capillary blood glucose g/L | From admission to discharge from hospital, assessed up to 7 days |
| Cardiovascular history and risk factors | Cardiovascular history and risk factors : questionnaire on medical history and prior related treatments (anticoagulant, antiplatelet agent, analgesic, oxygen therapy, statin, beta blocker, ACE inhibitor, angiotensin II receptor blocker). | From admission to discharge from hospital, assessed up to 7 days |
| Biological workup : troponin | Troponin (1st, 2nd ; 3rd measurement) (ng/mL) | From admission to discharge from hospital, assessed up to 7 days |
| Biological work-up : NT-proBNP | NT-proBNP (ng/mL) | From admission to discharge from hospital, assessed up to 7 days |
| Biological workup : hemoglobin | hemoglobin (g/dL) | From admission to discharge from hospital, assessed up to 7 days |
| Biological workup : BNP | BNP (ng/mL) | From admission to discharge from hospital, assessed up to 7 days |
| Biological workup : platelets count | platelets (10^9/L or Giga/L) | From admission to discharge from hospital, assessed up to 7 days |
| Biological workup : mean corpuscular volume | mean corpuscular volume (fL or µm3) | From admission to discharge from hospital, assessed up to 7 days |
| Biological workup : potassium | potassium (mmol/L) | From admission to discharge from hospital, assessed up to 7 days |
| Biological workup : creatinine | creatinine (µmol/L) | From admission to discharge from hospital, assessed up to 7 days |
| Biological workup : creatinine clearance | creatinine clearance (mL/min/1,73m2) | From admission to discharge from hospital, assessed up to 7 days |
| Electrocardiogram (ECG) | Electrocardiogram (ECG) : presence or absence of ST elevation, T wave inversion, pathological | From admission to discharge from hospital, assessed up to 7 days |
| Centre Hospitalier de Sélestat | Séléstat | Bas-Rhin | 67606 | France |
|
| Hôpitaux Universitaires de Strasbourg (NHC) | Strasbourg | Bas-Rhin | 67091 | France |
|
| Hôpital Louis Pasteur | Colmar | Haut-rhin | 68024 | France |
|
| Hôpital Emilie Muller | Mulhouse | Haut-rhin | 68100 | France |
|
| Hôpital Maison Blanche | Reims | Marne | 51092 | France |
|
| CHRU de Nancy | Nancy | Meurthe-et-Moselle | 54000 | France |
|
| Centre Hospitalier de Pont-à-Mousson | Pont-à-Mousson | Meurthe-et-Moselle | 54701 | France |
|
| Centre Hospitalier de Toul Saint-Charles | Toul | Meurthe-et-Moselle | 54200 | France |
|
| CHU de Poitiers, la Milétrie | Poitiers | Vienne | 86000 | France |
|
| 35016208 | Background | Timmis A, Vardas P, Townsend N, Torbica A, Katus H, De Smedt D, Gale CP, Maggioni AP, Petersen SE, Huculeci R, Kazakiewicz D, de Benito Rubio V, Ignatiuk B, Raisi-Estabragh Z, Pawlak A, Karagiannidis E, Treskes R, Gaita D, Beltrame JF, McConnachie A, Bardinet I, Graham I, Flather M, Elliott P, Mossialos EA, Weidinger F, Achenbach S; Atlas Writing Group, European Society of Cardiology. European Society of Cardiology: cardiovascular disease statistics 2021. Eur Heart J. 2022 Feb 22;43(8):716-799. doi: 10.1093/eurheartj/ehab892. |
| 30154043 | Background | Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD; Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth Universal Definition of Myocardial Infarction (2018). Glob Heart. 2018 Dec;13(4):305-338. doi: 10.1016/j.gheart.2018.08.004. Epub 2018 Aug 25. No abstract available. |
| 37622654 | Background | Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, Claeys MJ, Dan GA, Dweck MR, Galbraith M, Gilard M, Hinterbuchner L, Jankowska EA, Juni P, Kimura T, Kunadian V, Leosdottir M, Lorusso R, Pedretti RFE, Rigopoulos AG, Rubini Gimenez M, Thiele H, Vranckx P, Wassmann S, Wenger NK, Ibanez B; ESC Scientific Document Group. 2023 ESC Guidelines for the management of acute coronary syndromes. Eur Heart J. 2023 Oct 12;44(38):3720-3826. doi: 10.1093/eurheartj/ehad191. No abstract available. |
| 34020768 | Background | Collet JP, Thiele H, Barbato E, Barthelemy O, Bauersachs J, Bhatt DL, Dendale P, Dorobantu M, Edvardsen T, Folliguet T, Gale CP, Gilard M, Jobs A, Juni P, Lambrinou E, Lewis BS, Mehilli J, Meliga E, Merkely B, Mueller C, Roffi M, Rutten FH, Sibbing D, Siontis GCM; ESC Scientific Document Group. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Rev Esp Cardiol (Engl Ed). 2021 Jun;74(6):544. doi: 10.1016/j.rec.2021.05.002. No abstract available. English, Spanish. |
| ID | Term |
|---|---|
| D054058 | Acute Coronary Syndrome |
| D009203 | Myocardial Infarction |
| D000789 | Angina, Unstable |
| D016757 | Death, Sudden, Cardiac |
| D020521 | Stroke |
| D058729 | Peripheral Arterial Disease |
| D001145 | Arrhythmias, Cardiac |
| D004630 | Emergencies |
| D002318 | Cardiovascular Diseases |
| ID | Term |
|---|---|
| D017202 | Myocardial Ischemia |
| D006331 | Heart Diseases |
| D014652 | Vascular Diseases |
| D007238 | Infarction |
| D007511 | Ischemia |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D009336 | Necrosis |
| D000787 | Angina Pectoris |
| D002637 | Chest Pain |
| D010146 | Pain |
| D009461 | Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D006323 | Heart Arrest |
| D003645 | Death, Sudden |
| D003643 | Death |
| D002561 | Cerebrovascular Disorders |
| D001927 | Brain Diseases |
| D002493 | Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D050197 | Atherosclerosis |
| D001161 | Arteriosclerosis |
| D001157 | Arterial Occlusive Diseases |
| D016491 | Peripheral Vascular Diseases |
| D020969 | Disease Attributes |
Not provided
Not provided