Copeptin Testing During Pre-hospital Care in the Treatment of Chest Pain Suggestive of Acute Coronary Syndrome

Centre Hospitalier Universitaire de Nīmes320 enrolled

Overview

The main objective of our study is to evaluate the diagnostic value of copeptin testing in association with troponin HS testing during pre-hospital care (ambulance care) in the treatment of patients whose pattern of use is the occurrence chest pain suggestive of ACS but not ST+.

The secondary objectives of this study are to: A. Evaluate the diagnostic value of determination of copeptin testing in pre-hospital care in another diagnosis; B. Assess the prognostic value of copeptin assay on vital prognosis at day 28; C. Evaluate the kinetics of copeptin and troponin HS between initial ambulance care and arrival at the emergency department; D. Evaluate the potential impact of copeptin testing on pre-hospital patient care; E. Assess the economic impact of pre-hospital copeptin testing in terms of hospital stays and optimizing ambulance movements.

Study Type

OBSERVATIONAL

Enrollment

320

Conditions

Chest Pain

Interventions

Blood work in the ambulanceBIOLOGICAL

Blood sample for copeptin and troponin HS testing is taken during ambulance care.

Blood work upon arrival in the emergency roomBIOLOGICAL

Blood in drawn for copeptin and troponin HS testing upon arrival in the emergency room.

Blood work at 3 hours post-arrival in the emergency roomBIOLOGICAL

Blood is drawn for troponin HS testing 3 hours after the patient's arrival in the emergency room.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * all major adult patients taken in charge by the emergency ambulance services of the participating centers for non-traumatic chest pain for suspected ACS and an electrocardiogram initially excluding an ST segment elevation Exclusion Criteria: * The patient is participating in another study * The patient is in an exclusion period determined by a previous study * The patient is under judicial protection, under tutorship or curatorship * The patient (or a legal representative) formalizes his/her opposition for the study * It is impossible to correctly inform the patient * The patient is pregnant, parturient, or breastfeeding * The patient has a contraindication for a treatment used in this study * The patient's initial electrocardiogram indicates an ST segment elevation

Locations (2)

CHRU de Montpellier - Hôpital Lapeyronie

Montpellier, France

CHRU de Nîmes - Hôpital Universitaire Carémeau

Nîmes, France

Outcomes

Primary Outcomes

Blood troponin HS concentration (µg/L)

Time frame: Day 0, in the ambulance

Blood copeptin concentration (pmol/l)

Time frame: Day 0, in the ambulance

Final diagnosis of ACS non ST + (yes/no)

Time frame: Day 28

Secondary Outcomes

Blood troponin HS concentration (µg/L)

Time frame: Day 0, upon arrival in the emergency department

Blood troponin HS concentration (µg/L)

Time frame: Day 0, 3 hours after arrival in the emergency department

Mortality

Time frame: Day 28

Would you leave the patient at home if both copeptin and troponin tests were negative?

Yes/no question asked of ambulance doctors.

Time frame: Day O (in the ambulance)

Hospital costs (€) associated with avoidable services

Time frame: Day 28

Distance (km) between the hospital and the patient's place of residence

Time frame: Day 28

Time spent by ambulance staff at the patient's place of residence

Time frame: Day 0

Presence/absence of another diagnosis

Time frame: Day 28

Data from ClinicalTrials.gov

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