NCT05243485

Prehospital Triage of Patients With Suspected Non-ST-segment Elevation Acute Coronary Syndrome: the TRIAGE-ACS Study

Completed Last updated 12 February 2024

What this trial tests

trial testing PreHEART in ACS in 1,071 participants. Completed in 1 December 2023.

Timeline

1 April 2021

Primary endpoint
19 December 2022

1 December 2023

Quick facts

Lead sponsor	Catharina Ziekenhuis Eindhoven
Status	Completed
Study type	OBSERVATIONAL
Enrollment	1,071
Start date	1 April 2021
Primary completion	19 December 2022
Estimated completion	1 December 2023
Sites	1 location across Netherlands

Drugs / interventions tested

• PreHEART

Conditions studied

• ACS — all drugs for ACS →
• NSTEMI - Non-ST Segment Elevation MI — all drugs for NSTEMI - Non-ST Segment Elevation MI →
• Unstable Angina — all drugs for Unstable Angina →

Sponsor

Catharina Ziekenhuis Eindhoven — full company profile →

Who can join

18 and older, any sex, with ACS or NSTEMI - Non-ST Segment Elevation MI. Patients with the condition only — healthy volunteers not accepted.

Sponsor's own description

With the Emergency Medical Services (EMS), no prehospital risk stratification and triage is performed for patients suspected of having an Non-ST-segment elevation Acute Coronary Syndrome (NSTE-ACS). While the latest ESC Guidelines recommend an early invasive strategy within 24 hours for all high risk NSTE-ACS patients and same-day transfer to a PCI (Percutaneous Coronary Intervention) center. With the potential emerging logistical problem surrounding this, prehospital risk stratification and triage can have great benefits in this population as well, especially in patients with a high risk of having an NSTE-ACS. The recently validated PreHEART score makes it possible to stratify patients in a low-risk and high-risk group for having a NSTE-ACS and gives the EMS the opportunity to make triage decisions in the prehospital setting. Patients with a high risk for having an NSTE-ACS are transferred directly to an PCI-center for further diagnostic work-up. Patients with a low risk for having NSTE-ACS and transferred to the ED of the nearest hospital without PCI facilities (non-PCI center) for further diagnostic work-up, resulting in an optimization of the regional care utilization.

This is the first study to focus on patients who are at a high risk of having an NSTE-ACS and to assess if whether prehospital triage using the PreHEART score is able to significantly reduce time to final invasive diagnostics and revascularization in patients in need of coronary revascularization.

Publications & conference data

3 peer-reviewed publications reference this trial (live from Europe PMC):

1. Prehospital risk assessment in patients suspected of non-ST-segment elevation acute coronary syndrome: a systematic review and meta-analysis.
   Demandt JPA, Zelis JM, Koks A, Smits GHJM, et al · · 2022 · cited 12× · PMID 35383078 · DOI 10.1136/bmjopen-2021-057305
2. Prehospital risk assessment and direct transfer to a percutaneous coronary intervention centre in suspected acute coronary syndrome.
   Demandt J, Koks A, Sagel D, van Hattem VAE, et al · · 2024 · cited 8× · PMID 38040452 · DOI 10.1136/heartjnl-2023-323346
3. External validation of the preHEART score and comparison with current clinical risk scores for prehospital risk assessment in patients with suspected NSTE-ACS.
   Demandt JPA, Koks A, Sagel D, Haest R, et al · · 2024 · cited 4× · PMID 39074964 · DOI 10.1136/emermed-2023-213866