ArticleCritical pathways in cardiology2015
Performance of the EDACS-accelerated Diagnostic Pathway in a Cohort of US Patients with Acute Chest Pain.
Article in Critical pathways in cardiology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04381260 (RUral dispaRities in prehospitAL STEMI), which is not on this map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
RUral dispaRities in prehospitAL STEMI
Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of the applicability of emergency department assessment of chest pain score-accelerated diagnostic protocol for risk stratification of patients with chest pain.Clinical cardiology · 2023Pooled it
- Validation of a 0/2-Hour Point-Of-Care High Sensitivity Troponin Algorithm: A Multisite US Study.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2026Article
- Article
- Characterizing pre-discharge interventions to reduce length of stay for older adults: A scoping review.PloS one · 2025Article
- Scoring systems for the triage and assessment of short-term cardiovascular risk in patients with acute chest pain.Reviews in cardiovascular medicine · 2021Review
- The ethical dilemma of emergency department patients with low-risk chest pain.Emergency medicine journal : EMJ · 2021Article
- Comparison of accelerated diagnostic pathways for acute chest pain risk stratification.Heart (British Cardiac Society) · 2020Article
- Chest Pain Evaluation in the Emergency Department: Risk Scores and High-Sensitivity Cardiac Troponin.Current cardiology reports · 2020Review
- Risk stratification of patients with chest pain or anginal equivalents in the emergency department.Internal and emergency medicine · 2020Article
- Prehospital use of a modified HEART Pathway and point-of-care troponin to predict cardiovascular events.PloS one · 2020Article
- Undetectable Concentrations of a Food and Drug Administration-approved High-sensitivity Cardiac Troponin T Assay to Rule Out Acute Myocardial Infarction at Emergency Department Arrival.Academic emergency medicine : official journal of the Society for Academic Emergency Medicine · 2017Observational
- The Fast and the Furious: Low-Risk Chest Pain and the Rapid Rule-Out Protocol.The western journal of emergency medicine · 2017Review
Corrections and comments
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Authors and funding
11 authors.
Funding
Abstract
backgroundThe Emergency Department Assessment of Chest pain Score-Accelerated Diagnostic Protocol (EDACS-ADP) is a decision aid designed to safely identify emergency department (ED) patients with chest pain for early discharge. Derivation and validation studies in Australasia have demonstrated high sensitivity (99%-100%) for major adverse cardiac events (MACE).
objectivesTo validate the EDACS-ADP in a cohort of US ED patients with symptoms suspicious for acute coronary syndrome (ACS).
methodsA secondary analysis of participants enrolled in the HEART Pathway Randomized Controlled Trial was conducted. This single-site trial enrolled 282 ED patients≥21 years old with symptoms concerning for ACS, inclusive of all cardiac risk levels. Each patient was classified as low risk or at risk by the EDACS-ADP based on EDACS, electrocardiogram, and serial troponins. Potential early discharge rate and sensitivity for MACE at 30 days, defined as cardiac death, myocardial infarction (MI), or coronary revascularization were calculated.
resultsMACE occurred in 17/282 (6.0%) participants, including no deaths, 16/282 (5.6%) with MI, and 1/282 (0.4%) with coronary revascularization without MI. The EDACS-ADP identified 188/282 patients [66.7%, 95% confidence interval (CI): 60.8%-72.1%] as low risk. Of these, 2/188 (1.1%, 95% CI: 0.1%-3.9%) had MACE at 30 days. EDACS-ADP was 88.2% (95% CI: 63.6%-98.5%) sensitive for MACE, identifying 15/17 patients. Of the 2 patients identified as low risk with MACE, 1 had MI and 1 had coronary revascularization without MI.
conclusionsWithin a US cohort of ED patients with symptoms concerning for ACS, sensitivity for MACE was 88.2%. We are unable to validate the EDACS-ADP as sufficiently sensitive for clinical use.
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