Clinical trial NCT05902130: Symptoms of Acute Coronary Syndrome in Medical Regulation
Official title: Symptoms of Acute Coronary Syndrome in Medical Regulation: a Retrospective Study
Study type: OBSERVATIONAL
Overall status: COMPLETED
Conditions: Acute Coronary Syndrome
Keywords: acute coronary syndrome
out-hospital care
medical regulation
Lead sponsor: Centre Hospitalier Régional Metz-Thionville
Sponsor class: OTHER
First posted: 2023-06-13
Enrollment: 208
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Observational model: COHORT
Time perspective: RETROSPECTIVE
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.

Brief summary: 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.


Eligibility criteria: 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

Primary outcomes:
measure: Delay between the call to the emergency center and the first contact with a physician
timeFrame: End of the call to the emergency center, less than 10 min
Secondary outcomes:
measure: Delay between the call to the emergency center and the first electrocardiogram
timeFrame: At hospital discharge, an average of 2 hours
measure: Dispatch of a medical ambulance (Y/N)
timeFrame: End of the call to the emergency center, an average of 20 min
measure: Delay between the call to the emergency center and the first coronary angiography
timeFrame: At hospital discharge, an average of 2 hours
measure: In-hospital mortality
timeFrame: 30 days after the call to emergency center
measure: Day 30 mortality
timeFrame: 30 days after the call to emergency center
measure: Left Ventricular Ejection Fraction
timeFrame: At hospital discharge, less than 30 days
Other outcomes:
Locations:
city: Metz
country: France
facility: CHR Metz-Thionville/Hopital de Mercy
Study officials:
affiliation: CHR Metz Thionville Hopital de Mercy
name: Laure ABENSUR VUILLAUME, MD, PhD
role: PRINCIPAL_INVESTIGATOR
References: