Related Experiment Video

Updated: Mar 6, 2026

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

24.8K

The HEART-GP strategy for ruling out acute coronary syndrome in out-of-hours primary care: a diagnostic accuracy

Indra M B Melessen1,2,3, Jelle C L Himmelreich1,2,3, Amy Manten1,2,3

  • 1Amsterdam UMC, University of Amsterdam, Academic Medical Center, Department of General Practice, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands.

Contemporary Clinical Trials Communications
|March 5, 2026
PubMed

Insights

The HEART-GP strategy uses high-sensitivity troponin point-of-care testing to safely and efficiently diagnose acute coronary syndrome (ACS) in out-of-hours primary care. This approach aims to reduce missed ACS cases and unnecessary emergency department referrals.

Area of Science:

  • Cardiology
  • Primary Care Medicine
  • Diagnostic Accuracy Studies

Background:

  • Acute coronary syndrome (ACS) diagnosis is challenging in out-of-hours primary care (OOH-PC) due to non-specific symptoms and limited resources.
  • Current guidelines recommend emergency department (ED) referral, but ACS cases are still missed.
  • High-sensitivity troponin (hs-troponin) point-of-care testing (POCT) offers potential for faster, safer ACS diagnosis.

Purpose of the Study:

  • To evaluate the diagnostic accuracy and efficiency of the HEART-GP strategy in OOH-PC settings.
  • To compare the HEART-GP strategy against standard care for diagnosing ACS.
  • To assess the potential for reducing ED referrals and improving patient outcomes.

Main Methods:

  • A multicenter prospective diagnostic accuracy trial involving adults presenting with acute chest pain to Dutch OOH-PC centers.
  • The HEART-GP strategy combines a single fingerstick hs-troponin test with clinical assessment and optional ECG.
  • Primary outcome: major adverse cardiovascular events within six weeks. Secondary outcomes: diagnostic safety (sensitivity, NPV) and efficiency (ED referral reduction).

Main Results:

  • The HEART-GP strategy is anticipated to demonstrate improved diagnostic safety and efficiency in OOH-PC.
  • This strategy aims for a rapid rule-out of ACS, potentially reducing unnecessary ED referrals.
  • Further analysis will explore sex-specific cut-offs and integration with existing risk scores.

Conclusions:

  • The HEART-GP strategy shows promise for widespread implementation in primary care for acute chest pain evaluation.
  • This approach could enhance the timely and accurate diagnosis of ACS in primary care settings.
  • Improved diagnostic capabilities in OOH-PC can lead to better patient management and outcomes.
Abstract

Keywords:
After hours careChest painHs-troponin POCTMajor adverse cardiac eventsPrimary health careRisk stratification scores

More Related Videos

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders05:58

Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders

Published on: February 3, 2021

4.4K
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease06:16

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

1.0K

Related Concept Videos

Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
351
Acute Coronary Syndrome IV: Interprofessional Care01:28

Acute Coronary Syndrome IV: Interprofessional Care

IntroductionThe management of Acute Coronary Syndrome (ACS) aims to minimize myocardial damage, preserve myocardial function, and prevent complications.Initial ManagementInpatient management involves continuous cardiac monitoring, preferably in an ICU, focusing on blood pressure, serum sodium, potassium, and creatinine levels, and urine output. Ongoing pharmacologic management is crucial for stabilizing the patient.Supplemental Oxygen: Administer supplemental oxygen if oxygen saturation is...
356
Coronary Artery Disease V: Interprofessional Care01:27

Coronary Artery Disease V: Interprofessional Care

Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
352
Angina V: Nursing Management01:20

Angina V: Nursing Management

Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
440
Acute Coronary Syndrome V: Nursing Management01:26

Acute Coronary Syndrome V: Nursing Management

Nursing Assessment:Nursing management of acute coronary syndrome (ACS) involves taking the patient's history, focusing on primary complaints such as chest pain, dyspnea, and excessive sweating (diaphoresis), as well as other symptoms like back or jaw pain, nausea, vomiting, palpitations, dizziness, and fatigue. The nurse also reviews the patient's history of cardiac events, risk factors such as hypertension, diabetes, smoking, family history, and current medications.In the objective assessment,...
426
Pulse rhythm01:30

Pulse rhythm

Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
1.5K