August 31, 2017The Medical Journal of Australia
Improved Assessment of Chest pain Trial (IMPACT): assessing patients with possible acute coronary syndromes
Why the study?
Does the IMPACT protocol safely and efficiently assess risk of ACS in patients presenting to the emergency department with chest pain?
Population
1366 prospectively recruited patients presenting to the emergency department with symptoms of suspected…
Design
Cohort
Follow-up
30 days
Authors
Discussion
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Member takes
Implication
May support early discharge of low-risk ED chest pain patients via IMPACT; leaves open need for randomized validation.
Structured PICO
Does the IMPACT protocol safely and efficiently assess risk of ACS in patients presenting to the emergency department with chest pain?
P
Population
1366 prospectively recruited patients presenting to the emergency department with symptoms of suspected acute coronary syndrome (ACS) at a single tertiary referral hospital.
I
Intervention
IMPACT protocol (accelerated assessment strategy: high-risk treated per guidelines; low and intermediate-risk underwent sensitive troponin testing at 0 and 2 hours; intermediate-risk underwent objective testing after second troponin; low-risk discharged without further objective testing).
O
Outcome
Acute coronary syndrome (ACS) within 30 days of presentationhard clinical
The IMPACT protocol using 0- and 2-hour sensitive troponin testing safely and efficiently stratifies ED patients with chest pain, allowing early discharge of low-risk patients with no 30-day ACS events.
Cite This Study
Cullen et al. (2017) studied this question.