Could paramedics use the HEART Pathway to identify patients at low-risk of myocardial infarction in the pre-hospital setting?

Nicholas L Mills; Jack Andrews; Shruti Joshi; Evangelos Tzolos; Maaz Syed; Hayley Cuthbert; Livia E Crica; Neus Lozano; Emmanuel Okwelogu; Jennifer Raftis; Lorraine  Bruce; Craig Poland; Rodger Duffin; Paul H. B. Fokkens; A John F Boere; Daan L. A. C. Leseman; Ian Megson; Phillip D. Whitfield; Kerstin Ziegler; Seshu Tammireddy; Marilena Hadjidemetriou; Cyrill Bussy; Flemming R. Cassee; David E Newby; Kostas Kostarelos; Mark R Miller

doi:10.1016/j.ahj.2024.02.018

Could paramedics use the HEART Pathway to identify patients at low-risk of myocardial infarction in the pre-hospital setting?

Nicholas L Mills, Jack Andrews, Shruti Joshi, Evangelos Tzolos, Maaz Syed, Hayley Cuthbert, Livia E Crica, Neus Lozano, Emmanuel Okwelogu, Jennifer Raftis, Lorraine Bruce , Craig Poland, Rodger Duffin, Paul H. B. Fokkens, A John F Boere, Daan L. A. C. Leseman, Ian Megson, Phillip D. Whitfield, Kerstin Ziegler, Seshu TammireddyMarilena Hadjidemetriou, Cyrill Bussy, Flemming R. Cassee, David E Newby, Kostas Kostarelos, Mark R Miller

Research output: Contribution to journal › Article › peer-review

Abstract

In the Emergency Department, patients with suspected myocardial infarction can be risk stratified using the HEART pathway, which has recently been amended for pre-hospital use and modified for the incorporation of a high-sensitivity cardiac troponin test. In a prospective analysis, the performance of both HEART pathways in the pre-hospital setting, with a high-sensitivity cardiac troponin test using three different thresholds, was evaluated for major adverse cardiac events at 30 days. We found that both low-risk HEART pathways, when using the most conservative cardiac troponin thresholds, approached but did not reach accepted rule-out performance in the Emergency Department.

Original language	English
Journal	American Heart Journal
Early online date	23 Apr 2024
DOIs	https://doi.org/10.1016/j.ahj.2024.02.018
Publication status	E-pub ahead of print - 23 Apr 2024

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10.1016/j.ahj.2024.02.018

Cite this

Mills, N. L., Andrews, J., Joshi, S., Tzolos, E., Syed, M., Cuthbert, H., Crica, L. E., Lozano, N., Okwelogu, E., Raftis, J., Bruce , L., Poland, C., Duffin, R., Fokkens, P. H. B., Boere, A. J. F., Leseman, D. L. A. C., Megson, I., Whitfield, P. D., Ziegler, K., ... Miller, M. R. (2024). Could paramedics use the HEART Pathway to identify patients at low-risk of myocardial infarction in the pre-hospital setting? American Heart Journal. Advance online publication. https://doi.org/10.1016/j.ahj.2024.02.018

@article{496f7979cfa24d5396e63ea4fa448066,

title = "Could paramedics use the HEART Pathway to identify patients at low-risk of myocardial infarction in the pre-hospital setting?",

abstract = "In the Emergency Department, patients with suspected myocardial infarction can be risk stratified using the HEART pathway, which has recently been amended for pre-hospital use and modified for the incorporation of a high-sensitivity cardiac troponin test. In a prospective analysis, the performance of both HEART pathways in the pre-hospital setting, with a high-sensitivity cardiac troponin test using three different thresholds, was evaluated for major adverse cardiac events at 30 days. We found that both low-risk HEART pathways, when using the most conservative cardiac troponin thresholds, approached but did not reach accepted rule-out performance in the Emergency Department.",

author = "Mills, {Nicholas L} and Jack Andrews and Shruti Joshi and Evangelos Tzolos and Maaz Syed and Hayley Cuthbert and Crica, {Livia E} and Neus Lozano and Emmanuel Okwelogu and Jennifer Raftis and Lorraine Bruce and Craig Poland and Rodger Duffin and Fokkens, {Paul H. B.} and Boere, {A John F} and Leseman, {Daan L. A. C.} and Ian Megson and Whitfield, {Phillip D.} and Kerstin Ziegler and Seshu Tammireddy and Marilena Hadjidemetriou and Cyrill Bussy and Cassee, {Flemming R.} and Newby, {David E} and Kostas Kostarelos and Miller, {Mark R}",

year = "2024",

month = apr,

day = "23",

doi = "10.1016/j.ahj.2024.02.018",

language = "English",

journal = "American Heart Journal",

issn = "0002-8703",