Prognostic Value of Non-invasive Index of Endothelial Function.

Study Overview
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Brief Summary
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The objective of this study is to determine the prognostic performance of endothelial function assessment, using endothelial peripheral arterial tonometry (Endo-PAT), associated to TIMI risk score, in patients consulting the emergency department for non-traumatic chest pain. To determine the sensitivity, specificity, negative and positive predictive value of this method that was not previously used for this purpose.

Detailed Description
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Chest pain is a frequent reason for consultation in the emergency room, which can be as much as 5 to 10% of consultants. Stratifying the cardiovascular risk for patients consulting for chest pain is sometimes difficult. The endothelium plays a crucial role in maintaining the tone and vascular integrity and in particular the secretion of vasodilator and vasoconstrictor mediators. In most vascular pathologies, this equilibrium will be broken by the attenuation of the vasodilating function of the endothelium. This is called endothelial dysfunction. Several tools for measuring endothelial function have been developed, the main characteristics of which are: noninvasive, reproducible, independent operators, predictive of the disease, safe for subjects, inexpensive and easy to use. In this study we will be interested in digital plethysmography which has shown its effectiveness in: Screening for cardiovascular risk in asymptomatic subjects. The risk of a new cardiovascular event in the sick. Evaluation of the response to certain therapies. Goal of the study : The objective of this study is to to determine the prognostic performance of endothelial function assessment, using endothelial peripheral arterial tonometry (Endo-PAT), associated to TIMI risk score, in patients consulting the emergency department for non-traumatic chest pain. To determine the sensitivity, specificity, negative and positive predictive value of this method that was not previously used for this purpose, hence the originality of this study.

Official Title
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Prognostic Value of Non-invasive Index of Endothelial Function in Emergency Department Patients With Undifferentiated Chest Pain

Conditions
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Chest Pain, Major Adverse Cardiovascular Events

Intervention / Treatment
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* Device: Digital plethysmography in stratifying the cardiovascular risk for patients consulting for chest pain


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Any patient ≥ 25 years consulting for chest pain in the emergency department from 8:00 am to 8:00 pm (for the unavailability of the endopat device during the guard). Exclusion Criteria: Chest pain of traumatic origin. Hemodynamic instability. Myocardial infarction requiring urgent revascularization. Parkinsonism: tremor problem. Refusal, communication problem.

Ages Eligible for Study
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Minimum Age: 25 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Intervention Model: Single Group Assignment
Interventional Model Description: Prospective
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Patient consulting for chest Pain in ED<br>Any patient ≥ 25 years consulting for chest pain in the emergency department from 8:00 am to 8:00 pm (for the unavailability of the endopat device during the guard). | Device: Digital plethysmography in stratifying the cardiovascular risk for patients consulting for chest pain<br>* To verify the contribution of digital plethysmography in stratifying the cardiovascular risk for patients consulting for chest pain<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prognostic performance of Endo-PAT in predincting major adverse cardiovascular events | To determine the sensitivity, specificity, negative and positive predictive value of the Endopat associated to TIMI risk score in the the prediction of major adverse cardiovascular events in patients consulting the emergency department for chest pain | 30 days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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endothelial function, chest pain, major adverse cardiovascular events, Endo-PAT