ArticleEmergency medicine journal : EMJ2022
Feasibility of prehospital identification of non-ST-elevation myocardial infarction by ECG, troponin and echocardiography.
Article in Emergency medicine journal : EMJ, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04223986 (Prehospital Risk Stratification in Acute Coronary Syndromes- Feasibility Trial), which is not on this map. Cited by 10 papers.
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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.
Prehospital Risk Stratification in Acute Coronary Syndromes- Feasibility Trial
Who cites it
10 citing papers in PubMed, 17 citations in OpenAlex.
- Comparison of Troponin in a Prehospital Blood Sample and Risk Scores.Diagnostics (Basel, Switzerland) · 2026Article
- Acceptability of Cardiovascular Disease Point-of-Care Diagnostics in Primary Care Settings: A Scoping Review.Health science reports · 2026Review
- Diagnostic and prognostic value of regional wall motion abnormalities in patients with non-ST-elevation myocardial infarction.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- Pre-Hospital Artificial Intelligence-Guided, Focused Echocardiography in Patients with Acute Chest Pain for Diagnosis of Acute Coronary Syndrome.Journal of clinical medicine · 2025Article
- How Close Are We to Patient-Side Troponin Testing?Journal of clinical medicine · 2024Review
- [Prehospital ultrasound in emergency medicine].Die Anaesthesiologie · 2024Article
- Exploring heart dissection techniques for enhancing anatomical education: a pilot study to replicate transthoracic echocardiography.Surgical and radiologic anatomy : SRA · 2024Article
- Identifying and Solving Gaps in Pre- and In-Hospital Acute Myocardial Infarction Care in Asia-Pacific Countries.Korean circulation journal · 2023Review
- Real-time Remote Expert-guided Echocardiography by Medical Students.The ultrasound journal · 2023Article
- External validation of the Manchester Acute Coronary Syndromes ECG risk model within a pre-hospital setting.Emergency medicine journal : EMJ · 2023Article
Corrections and comments
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Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrehospital identification and selection of treatment strategy in patients with suspected non-ST-elevation myocardial infarction (NSTEMI) is challenging. The aim of this study was to evaluate the feasibility and diagnostic accuracy of prehospital ECG, troponin T (TnT) and transthoracic echocardiography (TTE) acquired by paramedics in early identification of NSTEMI.
methodsConsecutive patients requesting an ambulance from Sorlandet Hospital, Norway due to chest pain between November 2017 and January 2020 were screened for inclusion in the study. One ambulance was equipped with ECG recorder, point-of-care TnT test and TTE scanner, and six paramedics were given necessary training. ECG, TnT result and TTE images were acquired prehospitally and transferred to an in-hospital cardiologist. NSTEMI was suspected in patients with ischaemic ECG changes, elevated TnT or myocardial regional wall motion abnormalities (RWMA) at TTE.
resultsA total of 253 patients were included in the study. ECG was interpretable by cardiologists in 243 (96%), TnT in 238 (94%) and TTE images in 240 (95%) patients. NSTEMI was the discharge diagnosis in 22 (9%) of these patients. Four (18%) patients with NSTEMI had ischaemic ECG changes, elevated TnT and RWMA at TTE. Eight (36%) patients with NSTEMI had positive findings at two of the diagnostic methods, six (27%) patients had positive findings at one, and four (18%) patients had no positive findings in any of the diagnostic methods. In three patients (14%) with NSTEMI, RWMA was the only positive test. The negative and positive predictive values for RWMA were 42% and 96%, respectively.
conclusionsPrehospital acquisition of ECG, TnT and interpretable TTE images by paramedics were feasible in most patients with chest pain. Based on these examinations, it was possible to identify the majority of cases with NSTEMI prehospitally and admit the patients directly to a hospital with facilities for percutaneous coronary intervention (PCI) for further treatment. TRIAL REGISTRATION NUMBER: NCT04223986.
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