Prehospital Evaluation and Economic Analysis of Different Coronary Syndrome Treatment Strategies

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

Get a concise snapshot of the trial, including recruitment status, study phase, enrollment targets, and key timeline milestones.

Recruitment Status

COMPLETED

Total Enrollment

446 participants

Study Classification

OBSERVATIONAL

Study Start Date

2009-02-28

Study Completion Date

2013-05-31

Brief Summary

Review the sponsor-provided synopsis that highlights what the study is about and why it is being conducted.

Despite remarkable gains in treatment over the last decade short-term mortality for those who survive to hospital with AT-elevation acute myocardial infarction (STEMI) remains high (5%-10%). Different studies have pointed out that reperfusion (intravenous fibrinolysis or percutaneous coronary interventions (PCI) and its timing are critical in decreasing STEMI patients' mortality. Studies of prehospital 12 lead electrocardiograms (12 lead PHECG) with advance emergency department (ED) notification suggest that there is a time to treatment advantage with this intervention. The use of 12 lead PHECG is not currently universal and part of standard treatment throughout the province. The purpose of the study is to follow STEMI study subjects during standard treatments and to compare the outcomes of subjects that received 12 lead PHECG with advanced ED notification in mixed rural/urban areas with outcomes of subjects treated in areas with only 3 lead PHECG monitoring and indirect ED notification. The investigators hypothesize that there will be a survival benefit for study subjects with 12 lead PHECG and advance ED notification in rural and urban environments through a reduction in door-to-reperfusion time and that 12 lead PHECG will be a cost-saving technology for the province of Ontario.

Related Clinical Trials

Explore similar clinical trials based on study characteristics and research focus.

Sonothrombolysis in Patients With STEMI

NCT03092089

ST-segment Elevation Myocardial Infarction

COMPLETED PHASE2

EUROpean Intracoronary Cooling Evaluation in Patients With ST-elevation Myocardial Infarction.

NCT03447834

Acute Myocardial Infarction Reperfusion Injury

UNKNOWN NA

Intramyocardial Haemorrhage in Patients With Primary STEMI

NCT03677466

Myocardial Infarction STEMI Myocardial Necrosis +1 more

COMPLETED NA

Thrombectomy in ST Elevation Myocardial Infarction, an Individual Patient Meta-analysis

NCT02552407

Myocardial Infarction Acute Coronary Syndromes

COMPLETED

Upfront Premedication For Reduction of Microvascular Obstruction and No-reflow in Treating ST-segment Elevation Myocardial Infarction

NCT05393557

STEMI Large Thrombus Burden No-Reflow Phenomenon

NOT_YET_RECRUITING NA

Detailed Description

Dive into the extended narrative that explains the scientific background, objectives, and procedures in greater depth.

Many studies have established that reperfusion reduces mortality in ST-elevation acute myocardial infarction (STEMI) patients; the earlier reperfusion therapy is delivered, the greater the mortality reduction. Most STEMI patient in Ontario still do not receive reperfusion therapy within established target times of \<30 minutes for fibrinolysis or \<90 minutes for PCI. 12 lead PHECG with advance ED notification may have a time to treatment impact in STEMI patients. However studies, investigating this intervention were all small, largely urban trials, and were carried out with advanced care paramedics. In Ontario, many emergency medical services (EMS) systems cover large rural regions, and are frequently staffed by primary care paramedics with only basic life support training. Thus, the benefit of 12 lead PHECG in these settings is unclear. In addition, no study has assessed the cost-effectiveness of 12 lead PHECG compared to 3 lead PHECG.

Conditions

See the medical conditions and disease areas that this research is targeting or investigating.

Myocardial Ischemia Myocardial Infarction

Study Design

Understand how the trial is structured, including allocation methods, masking strategies, primary purpose, and other design elements.

Observational Model Type

COHORT

Study Time Perspective

PROSPECTIVE

Study Groups

Review each arm or cohort in the study, along with the interventions and objectives associated with them.

1

3 lead ECG subjects with chest pain and suspected ischemia transported to the nearest receiving ED and not eligible for bypass based on transport time

No interventions assigned to this group

2

3 lead ECG subjects with chest pain and suspected ischemia transported to the nearest receiving ED and eligible for bypass based on transport time, if 12 lead PHECG was possible

No interventions assigned to this group

3

12 lead ECG subjects with prehospital notification transported to nearest receiving ED adn not eligible for bypass to PCI center based on transport time

No interventions assigned to this group

4

12 lead PHECG subjects with prehospital notification bypassed past the nearest receiving ED to the PCI center.

No interventions assigned to this group

Eligibility Criteria

Check the participation requirements, including inclusion and exclusion rules, age limits, and whether healthy volunteers are accepted.

Inclusion Criteria

* Call 911 for assistance
* Are suspected by the paramedics of having ischemic chest pain for greater than 30 minutes but less than 6 hours
* Be greater than or equal to 18 years of age
* Experience chest pain that fails to completely respond to nitrates as per standard provincial chest pain protocol.