BACKGROUND: The serum rise of cardiac troponin remains the gold standard for diagnosing non-ST elevation (NSTE) @entity583 ( @entity583 ) despite its delayed response. Novel methods for real-time detection of NSTEMI would result in more immediate initiation of definitive medical therapy and faster transport to facilities that can provide specialized cardiac care. METHODS: EMPIRE is an ongoing prospective, observational cohort study designed to quantify the magnitude of @entity63 -induced repolarization dispersion for the early detection of NSTEMI. In this ongoing study, prehospital ECG data is gathered from @entity1 who call 9-1-1 with a chief complaint of non-traumatic @entity662 . This data is then analyzed using the principal component analysis (PCA) technique of 12-lead ECGs to fully characterize the spatial and temporal qualities of STT waveforms. RESULTS: Between May and December of 2013, Pittsburgh EMS obtained and transmitted 351 prehospital ECGs of the 1149 @entity1 with @entity662 dispatches transported to participating hospitals. After excluding those with poor ECG signal (n=40, 11%) and those with pacing or LBBB (n=50, 14%), there were 261 eligible @entity1 (age 57  16years, 45% female, 45% Black). In this preliminary sample, there were 19 STEMI (7%) and 33 NSTEMI (12%). More than 50% of those with @entity1188 (STEMI or NSTEMI) had initially negative troponin values upon presentation. We present ECG data of such NSTEMI case that was identified correctly using our methods. CONCLUSIONS: Concrete ECG algorithms that can quantify NSTE @entity63 and allow differential treatment based on such ECG changes could have an immediate clinical impact on @entity1 outcomes. We describe the rationale, development, design, and potential usefulness of the EMPIRE study. The findings may provide insights that can influence guidelines revisions and improve public health.

Rationale, development, and implementation of the Electrocardiographic Methods for the Prehospital Identification of Non-ST Elevation XXXX Events (EMPIRE).

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity662 :: ('MESH:D002637', 'Disease') :: ['chest pain-related emergency', 'chest pain'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia'] @entity1188 :: ('MESH:D007238', 'Disease') :: ['infarction'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction', 'MI']
@entity583 :: (MESH:D009203,Disease) :: ['Myocardial Infarction']
