Symptoms of Acute Coronary Syndrome in Medical Regulation (SCAST+)

Symptoms of Acute Coronary Syndrome in Medical Regulation: a Retrospective Study

The main objective was to analyze the impact of the gender of the attending physician in the differences in the management of ST+ ACS between men and women.

This study will be conducted in partnership with the interventional cardiology team of the CHR Metz-Thionville and SAMU (emergency call center) of Moselle, which has a detailed registry of coronary angiographies at the center. A retrospective observational study will be carried out over a "typical" period outside of covid at the CHR Metz Mercy (2021-2022) based on coronary angiographies performed in the context of ST+ ACS at the CHR of patients referred by the center 15.

The patient's medical record will be analyzed, going back to his call to the 15 via tape listening. The number of subjects required being calculated at 104 men and 104 women, these patients will be selected from the database of our cardiologist colleagues and we will match one man to one woman by comparing the delays of several items (1st medical contact, time of 1st ECG, medicalization or not, delay of call to the cardiologist, delay of coronary angiography...) according to the sex of the regulator. The consequences of a difference in management will be also evaluated by analyzing in-hospital mortality, mortality at 30 days of management, and functional sequelae at discharge (grades of dyspnea, disturbance of myocardial contractility, LVEF at discharge).

This study based on the differences in questioning according to the gender of the regulating physician would allow better identification of the factors that increase the delay in the management of ST+ ACS in women, and to find avenues of correction in order to limit the loss of opportunity for patients.

The patients included who are still alive will receive a notification of non-objection by mail.

Study Overview

• Status: Completed
• Conditions: Acute Coronary Syndrome
• Intervention / Treatment: Other: symptoms of a myocardial infarction

• Study Type: Observational
• Enrollment (Actual): 208

Contacts and Locations

Study Locations

• France
  • Metz, France, 57085
    • CHR Metz-Thionville/Hopital de Mercy

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: N/A

• Sampling Method: Non-Probability Sample

Study Population

The cohort includes patients admitted for coronary angiography at the Mercy hospital center in 2021-2022, having had a confirmed diagnosis of ACS ST+ and who made an initial call to the Moselle SAMU.

Description

Inclusion Criteria:

• patient with emergency coronary angiography for ST+ ACS
• having made a call to the Emergency Center for the same reason

Exclusion Criteria:

• non-real ST+ ACS

Study Plan

How is the study designed?

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Delay between the call to the emergency center and the first contact with a physician	Delay (minutes:seconds)	End of the call to the emergency center, less than 10 min

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Delay between the call to the emergency center and the first electrocardiogram	Delay (hours:minutes)	At hospital discharge, an average of 2 hours
Dispatch of a medical ambulance (Y/N)	Number (%)	End of the call to the emergency center, an average of 20 min
Delay between the call to the emergency center and the first coronary angiography	Delay (minutes)	At hospital discharge, an average of 2 hours
In-hospital mortality	Number (%)	30 days after the call to emergency center
Day 30 mortality	Number (%)	30 days after the call to emergency center
Left Ventricular Ejection Fraction	Percentage	At hospital discharge, less than 30 days

Collaborators and Investigators

• Sponsor: Centre Hospitalier Régional Metz-Thionville
• Investigators: Principal Investigator: Laure ABENSUR VUILLAUME, MD, PhD, CHR Metz Thionville Hopital de Mercy

Study record dates

Study Major Dates

• Study Start (Actual): January 1, 2023
• Primary Completion (Actual): October 1, 2023
• Study Completion (Actual): October 1, 2023

Study Registration Dates

• First Submitted: May 22, 2023
• First Submitted That Met QC Criteria: June 5, 2023
• First Posted (Actual): June 13, 2023

Study Record Updates

• Last Update Posted (Actual): December 26, 2023
• Last Update Submitted That Met QC Criteria: December 22, 2023
• Last Verified: December 1, 2023

More Information

Terms related to this study

• Keywords: acute coronary syndrome; out-hospital care; medical regulation
• Additional Relevant MeSH Terms: Pathologic Processes; Myocardial Ischemia; Heart Diseases; Cardiovascular Diseases; Vascular Diseases; Disease; Syndrome; Acute Coronary Syndrome
• Other Study ID Numbers: 2023-03Obs-CHRMT

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No