Related Experiment Video

Updated: Feb 8, 2026

Author Spotlight: Evaluating the Adjuvant Efficacy and Safety of Angong Niuhuang Pill in Viral Encephalitis Treatment
08:36

Author Spotlight: Evaluating the Adjuvant Efficacy and Safety of Angong Niuhuang Pill in Viral Encephalitis Treatment

Published on: April 19, 2024

1.2K

The HEART Pathway Randomized Controlled Trial One-year Outcomes

Jason P Stopyra1, Robert F Riley2, Brian C Hiestand1

  • 1Department of Emergency Medicine, Wake Forest School of Medicine, Winston-Salem, NC.

Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine
|June 20, 2018
PubMed

Insights

The HEART Pathway demonstrated a 100% negative predictive value for major adverse cardiac events at one year in chest pain patients. This approach did not increase healthcare utilization, offering a safe and effective alternative to usual care.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Health Services Research

Background:

  • Acute chest pain is a common emergency department presentation requiring accurate risk stratification.
  • The HEART score and serial troponin measurements are established tools for assessing cardiac risk.
  • Optimizing diagnostic pathways can improve patient outcomes and healthcare resource utilization.

Purpose of the Study:

  • To evaluate the impact of the HEART Pathway on healthcare utilization and safety outcomes.
  • To assess the 1-year incidence of major adverse cardiac events (MACE) in patients managed with the HEART Pathway versus usual care.
  • To determine the negative predictive value of the HEART Pathway for safety outcomes.

Main Methods:

  • A randomized controlled trial involving 282 adult emergency department patients with chest pain.
  • Patients were assigned to either the HEART Pathway (using HEART score and troponin) or usual care.
  • Outcomes including MACE, objective testing, hospitalizations, and ED visits were assessed at 1 year.

Main Results:

  • No significant difference in 1-year MACE rates between the HEART Pathway (9.9%) and usual care (11.3%).
  • The HEART Pathway achieved 100% negative predictive value for MACE in low-risk patients.
  • Objective testing and cardiac-related healthcare utilization showed non-significant trends between groups.

Conclusions:

  • The HEART Pathway is a safe strategy for managing acute chest pain patients, offering 100% NPV for 1-year MACE.
  • It does not lead to increased downstream hospitalizations or emergency department visits.
  • Further research may explore optimizing objective testing within this pathway.
Abstract

More Related Videos

Author Spotlight: Advancements and Challenges in Surgical Treatments for Postamputation Pain03:26

Author Spotlight: Advancements and Challenges in Surgical Treatments for Postamputation Pain

Published on: March 8, 2024

3.6K
Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management03:53

Author Spotlight: Regenerative Peripheral Nerve Interface (RPNI) Surgery in Postamputation Pain Management

Published on: March 15, 2024

2.9K

Related Concept Videos

Clinical Trials: Overview01:11

Clinical Trials: Overview

Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
5.0K
Trial and Error and Algorithm01:12

Trial and Error and Algorithm

A problem-solving strategy is a plan of action used to find a solution. Different strategies have distinct action plans. Trial and error involves trying different solutions until one works. For instance, to fix a broken printer, you might check ink levels, ensure the paper tray isn't jammed, and verify the printer's connection to your laptop. This method can be time-consuming but is commonly used. Thomas Edison, for example, used trial and error to find a suitable filament for the light...
425
Clinical Trials01:16

Clinical Trials

Clinical trials are prospective experimental studies conducted on humans to determine the safety and efficacy of treatments, drugs, diet methods, and medical devices. Using statistics in clinical trials enables researchers to derive reasonable and accurate conclusions from the collected data, allowing them to make wise decisions in uncertain situations. In medical research, statistical methods are crucial for preventing errors and bias.
There are four phases in a clinical trial. A phase one...
10.8K
Predicting Reaction Outcomes02:24

Predicting Reaction Outcomes

Kinetics describes the rate and path by which a reaction occurs. In contrast, thermodynamics deals with state functions and describes the properties, behavior, and components of a system. It is not concerned with the path taken by the process and cannot address the rate at which a reaction occurs. Although it does provide information about what can happen during a reaction process, it does not describe the detailed steps of what appears on an atomic or a molecular level. On the other hand,...
10.9K
Outcomes of Glycolysis01:13

Outcomes of Glycolysis

Nearly all the energy used by cells comes from the bonds that make up complex organic compounds. These organic compounds are broken down into simpler molecules, such as glucose. As a result, cells extract energy from glucose over many chemical reactions—a process called cellular respiration.
Cellular respiration can occur aerobically (with oxygen) or anaerobically (without oxygen). In the presence of oxygen, cellular respiration starts with glycolysis and continues with pyruvate...
107.4K
Random Error01:04

Random Error

Random or indeterminate errors originate from various uncontrollable variables, such as variations in environmental conditions, instrument imperfections, or the inherent variability of the phenomena being measured. Usually, these errors cannot be predicted, estimated, or characterized because their direction and magnitude often vary in magnitude and direction even during consecutive measurements. As a result, they are difficult to eliminate. However, the aggregate effect of these errors can be...
9.8K