University of Edinburgh

Dr Michael McDermott

HDR UK

DL_2022_044

Chest pain is one of the most common reasons for presentation to hospital worldwide, with more than one million attendances each year in the United Kingdom. Thankfully most people with chest pain are not experiencing a heart attack, but it often takes time and healthcare resources to rule-out this important diagnosis. Newer blood tests can now reassure patients and clinicians earlier after presentation to hospital in those who are not having a heart attack. However, there is variation in how these tests and clinical pathways are implemented across the UK. We will look at patient attendances with suspected heart attack and see how well patients are cared for, looking how care varies between men and women, different ages, and ethnic groups.

Chest pain is one of the most common reasons for presentation to hospital worldwide, with more than one million attendances each year in the United Kingdom alone. Most chest pain patients do not have acute myocardial infarction (heart attack) and guidelines now support the safety and effectiveness of newer accelerated rule-out pathways. These use very low concentrations of a blood marker for cardiac injury (cardiac troponin). However, multiple pathways have been proposed that vary according to cardiac troponin thresholds used for decision-making and timing of sampling. Implementing early rule-out pathways for acute chest pain could save healthcare resources and improve the safe delivery of patient care, potentially saving a quarter of a million hospital admissions across the UK per annum. However, the effectiveness and safety of these pathways in routine practice remains uncertain and there is likely to be substantial variation by region and by age, sex and ethnic groups. This work will create UK data infrastructure to enable monitoring patients assessed for possible myocardial infarction and enable understanding of the variation of service across different regions of the UK. This has potential to improve care for patients in these regions.

Health Services & Delivery

21/04/2023

De-Personalised

TRE