Differential Diagnosis and Risk Stratification in Patients With Suspected NSTEACS

National Research Center for Preventive Medicine140 enrolled

Overview

To evaluate possibilities of rapid differential diagnosis and risk stratification in patients urgently admitted to the CCU with a suspected acute coronary syndrome without persistent ST-segment elevation (NSTEACS).

Single centre prospective non-randomised non-comparative study of patients delivered by ambulance and admitted to the CCU with suspected NSTEACS. Aims of this study are: 1. To characterize the contingent of patients admitted to the CCU with suspected NSTEACS. 2. To evaluate possibilities of fast differential diagnosis and risk stratification in patients admitted to the CCU with suspected NSTEACS using clinical data, ECG, biomarker levels (hsTn, NT-proBNP, hsCPR, cardiac FABP) as well as HEART, ADAPT, EDACS, T-MACS, GRACE, ACTION and TIMI scores. 3. To evaluate the correlation between clinical data, ECG, biomarker levels (hsTn, NT-proBNP, hsCPR, cardiac FABP) as well as HEART, ADAPT, EDACS, T-MACS, GRACE, ACTION and TIMI scores with presence and severity of coronary atherosclerosis in patients admitted to the CCU (intensive care unit) with suspected NSTEACS.

Study Type

OBSERVATIONAL

Enrollment

140

Conditions

Non ST Segment Elevation Acute Coronary Syndrome

Interventions

Approaches to differential diagnosis and risk stratificationDIAGNOSTIC_TEST

Detailed analysis of clinical course, ECG, biomarkers (hsTn I, CK-MB mass, myoglobin, NT-proBNP, hsCPR, cardiac FABP on admission and after 3 hours; hsTn I, CK-MB mass and myoglobin after 6 hours if needed) as well as HEART, ADAPT, EDACS, T-MACS, GRACE, ACTION and TIMI scores.

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: 1. Delivered by ambulance to the CCU with suspected diagnosis "acute coronary syndrome (ACS)". 2. Signed informed consent. Exclusion Criteria: 1. ACS with persistent ST-segment elevation. 2. Moribund; extremely severe condition on admission with a potentially unfavourable prognosis (cardiogenic shock, coma, cardiac arrest, an urgent need for mechanical ventilation). 3. Overt non-cardiac cause of clinical manifestations at the time of admission (bleeding, pulmonary embolism, aortic dissection, stroke).

Locations (1)

Eramishantsev Hospital

Moscow, Russia

Outcomes

Primary Outcomes

Clinical outcomes

Composite of death, (re) infarction, stroke or re-hospitalization

Time frame: 6 monts

Final diagnosis

Final diagnosis - the main reason for urgent hospitalization - according to hospital case history

Time frame: Up to 1 monts

Secondary Outcomes

Death

Death upon discharge and up to 6 months

Time frame: 6 months.

(re) infarction

(re) infarction upon discharge and up to 6 months

Time frame: Up to 1 monts

Stroke

Stroke upon discharge and up to 6 months

Time frame: 6 months.

Re-hospitalization

Recurrent hospital admissions after discharge form the index hospitalization

Time frame: 6 months.

Data from ClinicalTrials.gov

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