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.
Study Type
OBSERVATIONAL
Enrollment
10,000
Acute chest pain patients, suspected acute coronary syndrome, are diagnosed by coronary angiography.
Acute chest pain patients, suspected acute aortic dissection, are diagnosed by gold standard of CTA.
Acute chest pain patients, suspected acute pulmonary embolism, are diagnosed by gold standard of CTA.
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.
Dynamic changes of cardiac troponin I and/or T will be used in the diagnosis of acute myocardial infarction
Affiliated Hospital of Zunyi Medical University
Zunyi, Guizhou, China
RECRUITINGChengdu Second People's Hospital
Chengdu, Sichuan, China
RECRUITINGChengdu Shangjin Nanfu Hospital
Chengdu, Sichuan, China
RECRUITINGSichuan Integrative Medicine Hospital
Chengdu, Sichuan, China
RECRUITINGWest China Hospital, Sichuan University
Chengdu, Sichuan, China
RECRUITINGPeople's Hospital of Xindu District
Chengdu, Sichuan, China
RECRUITINGAffiliated Hospital of Southwest Medical University
Luzhou, Sichuan, China
RECRUITINGPanzhihua Central Hospital
Panzhihua, Sichuan, China
RECRUITINGZigong Fourth People's Hospital
Zigong, Sichuan, China
RECRUITINGRate of participants with all-cause death
Patients die of all causes during hospitalization or follow-up
Time frame: One year
Rate of participants with cardiovascular death
Patients die of cardiac and cerebrovascular diseases during hospitalization or follow-up
Time frame: One year
Rate of participants with major adverse cardiac events (MACEs)
MACEs include cardiac death, stroke, and recurrent myocardial infarction.
Time frame: 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
Time frame: 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.
Time frame: 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.
Time frame: 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.
Time frame: Twenty-four hours
Rate of participants with ischemia or necrosis of lower limbs
Patients complicate with ischemia or necrosis of lower limbs during hospitalization
Time frame: Two weeks
Rate of participants with acute heart failure
Patients complicate with acute heart failure during hospitalization
Time frame: Two weeks
Rate of participants with revascularization
Patients receive revascularization for recurrent angina or myocardial infarction during hospitalization
Time frame: Two weeks
Rate of participants with consciousness disorder
Patients complicate with consciousness disorder during hospitalization
Time frame: Two weeks
Rate of participants with cardiogenic shock
Patients complicate with cardiogenic shock during hospitalization
Time frame: Two weeks
Rate of participants with acute kidney injury
Patients complicate with acute kidney injury during hospitalization
Time frame: Two weeks
Rate of participants with malignant arrhythmia
Patients complicate with malignant arrhythmia during hospitalization
Time frame: Two weeks
Rate of participants with pericardial tamponade
Patients complicate with pericardial tamponade during hospitalization
Time frame: Two weeks
Rate of participants with bleeding
Patients complicate with bleeding
Time frame: One year
Rate of participants with multiple organ dysfunction syndrome
Patients complicate with multiple organ dysfunction syndrome during hospitalization
Time frame: Two weeks
Rate of participants with respiratory failure
Patients complicate with respiratory failure during hospitalization
Time frame: 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.
Time frame: Two weeks
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