TY - JOUR
T1 - Evaluation and management of patients with acute chest pain in China (EMPACT)
T2 - Protocol for a prospective, multicentre registry study
AU - Zheng, Wen
AU - Wang, Jiali
AU - Xu, Feng
AU - Zheng, Jiaqi
AU - Zhang, He
AU - Ma, Jingjing
AU - Wang, Guangmei
AU - Wang, Hao
AU - Chew, Derek P.
AU - Chen, Yuguo
N1 - Funding Information:
1Department of Emergency and Chest Pain Center, Qilu Hospital, Shandong University, Jinan, China 2Key Laboratory of Emergency and Critical Care Medicine of Shandong Province, Qilu Hospital, Shandong University, Jinan, China 3Institute of Emergency and Critical Care Medicine, Shandong University, Jinan, China 4Key Laboratory of Cardiovascular Remodeling and Function Research, Chinese Ministry of Education and Chinese Ministry of Public Health, Qilu Hospital, Shandong University, Jinan, China 5Department of Cardiovascular Medicine, Flinders University, Adelaide, Australia Contributors YC contributed to the initiation, planning and conduction of the study. WZ, JW, HZ, JM, GW and JZ conducted the study supervision. WZ, JW and FX contributed equally to the manuscript of protocol. DPC advised on the study design and performed a critical revision of the manuscript. HW provided the statistical analysis. JW, WZ and HW performed the analysis and interpretation of data. Funding This work was supported by Taishan Scholar Program of Shandong Province (ts20130911), Taishan Young Scholar Program of Shandong Province (tsqn20161065), Key Technology Research and Development Program of Science and Technology of Shandong Province (2014kjhm0102), Department of Science and Technology of Shandong Province (2014GSF118111, 2016GSF201235, 2016ZDJS07A14).
Publisher Copyright:
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Introduction Acute chest pain represents a major healthcare burden in emergency departments (ED) throughout the world. Among these patients, rapidly determining whether an acute coronary syndrome (ACS) is evolving remains difficult. In China, there are limited data correlating the baseline characteristics, evaluation and management of ED patients with acute chest pain and ACS-related symptoms with clinical outcomes. Nor has there been an evaluation of outcomes at different levels of hospitals. The Evaluation and Management of Patients with Acute ChesT pain in China (EMPACT) study will address this evidence gap through a regional representative prospective registry. Methods and analysis Twenty-two public hospitals with ED in Shandong province have been selected based on a stratified random sampling approach. A total of 10 000 patients with acute chest pain or suspected ACS presenting to the ED will be consecutively enrolled from January 2016 to September 2017. Episodes of care will be evaluated for key performance measures such as the time to first ECG, receipt of troponin testing, receipt of reperfusion therapy for ST segment elevation ACS and provision of angiography for troponin-positive patients. All patients will be assessed for the composite endpoint of adjudicated major adverse cardiac events in 30 days after presentation, including death from all causes, non-fatal myocardial infarction, urgent revascularisation, stroke, cardiac arrest and cardiogenic shock. The secondary outcomes include revisit to ED and rehospitalisation within 30 days. Ethics and dissemination Ethics approval was obtained at all participating centres. The registry is the first attempt to comprehensively evaluate the current emergency care of acute chest pain from a regional representative sample in China. Findings will allow new opportunities to facilitate the clinical quality improvements and ultimately reduce the mortality in patients with acute chest pain and suspected ACS. Trial registration number NCT02536677; Pre-results.
AB - Introduction Acute chest pain represents a major healthcare burden in emergency departments (ED) throughout the world. Among these patients, rapidly determining whether an acute coronary syndrome (ACS) is evolving remains difficult. In China, there are limited data correlating the baseline characteristics, evaluation and management of ED patients with acute chest pain and ACS-related symptoms with clinical outcomes. Nor has there been an evaluation of outcomes at different levels of hospitals. The Evaluation and Management of Patients with Acute ChesT pain in China (EMPACT) study will address this evidence gap through a regional representative prospective registry. Methods and analysis Twenty-two public hospitals with ED in Shandong province have been selected based on a stratified random sampling approach. A total of 10 000 patients with acute chest pain or suspected ACS presenting to the ED will be consecutively enrolled from January 2016 to September 2017. Episodes of care will be evaluated for key performance measures such as the time to first ECG, receipt of troponin testing, receipt of reperfusion therapy for ST segment elevation ACS and provision of angiography for troponin-positive patients. All patients will be assessed for the composite endpoint of adjudicated major adverse cardiac events in 30 days after presentation, including death from all causes, non-fatal myocardial infarction, urgent revascularisation, stroke, cardiac arrest and cardiogenic shock. The secondary outcomes include revisit to ED and rehospitalisation within 30 days. Ethics and dissemination Ethics approval was obtained at all participating centres. The registry is the first attempt to comprehensively evaluate the current emergency care of acute chest pain from a regional representative sample in China. Findings will allow new opportunities to facilitate the clinical quality improvements and ultimately reduce the mortality in patients with acute chest pain and suspected ACS. Trial registration number NCT02536677; Pre-results.
KW - Acute Chest Pain
KW - Emergency Department
KW - Evaluation
KW - Management
KW - Outcomes
UR - http://www.scopus.com/inward/record.url?scp=85052183534&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2017-017872
DO - 10.1136/bmjopen-2017-017872
M3 - Article
C2 - 29362251
AN - SCOPUS:85052183534
VL - 8
JO - BMJ Open
JF - BMJ Open
IS - 1
M1 - e017872
ER -