Trial reportEuropean heart journal. Acute cardiovascular care2022
Referral decisions based on a pre-hospital HEART score in suspected non-ST-elevation acute coronary syndrome: final results of the FamouS Triage study.
Trial report in European heart journal. Acute cardiovascular care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06051110 (Individual Patient Data Meta-analysis on Prehospital Risk Assessment in Patients Suspected of Non-ST-segment Elevation Acute Coronary Syndrome), which is not on this map. Cited by 21 papers.
What it found
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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.
Individual Patient Data Meta-analysis on Prehospital Risk Assessment in Patients Suspected of Non-ST-segment Elevation Acute Coronary Syndrome
Who cites it
21 citing papers in PubMed, 36 citations in OpenAlex.
- Pre-hospital rule-out of non-ST-segment elevation acute coronary syndrome by a single troponin: final one-year outcomes of the ARTICA randomised trial.European heart journal. Quality of care & clinical outcomes · 2024Trial
- Accelerated -Rule-Out of acute Myocardial Infarction using prehospital copeptin and in-hospital troponin: The AROMI study.European heart journal · 2023Trial
- Rule-out of non-ST-segment elevation acute coronary syndrome by a single, pre-hospital troponin measurement: a randomized trial.European heart journal · 2023Trial
- Comparison of Troponin in a Prehospital Blood Sample and Risk Scores.Diagnostics (Basel, Switzerland) · 2026Article
- Cost-effectiveness of prehospital high-sensitivity troponin i testing versus standard emergency department care in patients with suspected acute coronary syndrome in France.Health economics review · 2026Article
- Performance of the HEART Score in pre-hospital settings for suspected non-ST-elevation acute coronary syndrome: The POPular HEART Study.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2026Article
- [Advances in the application of the HEART score in patients with acute coronary syndromes].Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences · 2026Review
- Agreement between ambulance paramedics and physicians on the (pre)hospital identification of low-risk chest pain patients.European journal of emergency medicine : official journal of the European Society for Emergency Medicine · 2026Article
- Cardiac troponin at the point of care in acute and chronic coronary syndromes.Diabetes, obesity & metabolism · 2025Review
- Towards prehospital risk stratification using deep learning for ECG interpretation in suspected acute coronary syndrome.BMJ health & care informatics · 2025Article
- Point-of-care tests in the emergency medical services: a scoping review.Scandinavian journal of trauma, resuscitation and emergency medicine · 2025Article
- How Close Are We to Patient-Side Troponin Testing?Journal of clinical medicine · 2024Review
- Pre-hospital evaluation of chest pain patients using the modified HEART-score: rationale and design.Future cardiology · 2024Observational
- AI Algorithm to Predict Acute Coronary Syndrome in Prehospital Cardiac Care: Retrospective Cohort Study.JMIR cardio · 2023Article
- Ready for rapid rule-out of acute myocardial infarction.European heart journal · 2023Article
- Prehospital stratification and prioritisation of non-ST-segment elevation acute coronary syndrome patients (NSTEACS): the MARIACHI scale.Internal and emergency medicine · 2023Observational
- Article
- Improved prehospital triage for acute cardiac care: results from HART-c, a multicentre prospective study.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2023Article
- HART-c: Prehospital triage via hospital consultation-the future lies in the ambulance.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2023Article
- Clinical decision rules in the pre-hospital triage of patients with chest pain.Netherlands heart journal : monthly journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation · 2023Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
aimsAlthough pre-hospital risk stratification of patients with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS) by ambulance paramedics is feasible, it has not been investigated in daily practice whether referral decisions based on this risk stratification is safe and does not increase major adverse cardiac events (MACE). In Phase III of the FamouS Triage study, it was investigated whether referral decisions by ambulance paramedics based on a pre-hospital HEART score, is non-inferior to routine management. METHODS AND
resultsFamouS Triage Phase III is a non-inferiority study, comparing the occurrence of MACE before (Phase II) and after (Phase III) implementation of referral decisions based on a pre-hospital HEART score. In Phase II, all patients were risk-stratified and referred to the hospital; in Phase III, low-risk patients (HEART score ≤ 3) were not referred. Primary endpoint was MACE (acute coronary syndrome, revascularization, or death) within 45 days. A total of 1236 patients were included. Mean age was 63 years, 43% were female, 700 patients were included in the second phase and 536 in the third phase in which 149 low-risk patients (28%) were not transferred to the hospital. Occurrence of 45 days MACE was 16.6% in Phase II and 15.7% in Phase III (P = 0.67). Percentage MACE in low-risk patients was 2.9% in Phase II and 1.3% in Phase III. After adjustments for differences in baseline variables, the hazard ratio of 45 days MACE in Phase III was 0.88 (95% confidence interval 0.63-1.25) as compared to Phase II.
conclusionPre-hospital risk stratification of patients with suspected NSTE-ACS, avoiding hospitalization of a substantial number of low-risk patients, seems feasible and non-inferior to transferring all patients to the hospital.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.