Coronary disease & ACSRandomised controlled trial
PreHEART score for emergency medical services triage of chest pain: a randomised trial
- Pragmatic, randomised, open-label, blinded-endpoint non-inferiority trial
- conducted in the Netherlands by Emergency Medical Services
Authors' conclusion
PreHEART-guided EMS conveyance was non-inferior to usual care for serious adverse events, reduced emergency department presentations and costs, and was associated with increased ACS detection and coronary angiography in women.
Study context
- Population
- Adults attended by EMS for undifferentiated chest painadults attended by EMS for undifferentiated chest pain, randomised
- Participants
- 5,170 adults
- Comparison
- PreHEART-guided care vs usual care
- Primary endpoint
- hierarchical composite of unexpected serious adverse events
- Follow-up
- 3 days
Primary result
As reported in the abstract
Win ratio
1.01
95% CI 0.89–1.16
P < 0.001
PreHEART-guided care vs usual care
win ratio 1.01 (95% CI 0.89–1.16); P < 0.001
Further findings
Non-conveyance
| Outcome | RR |
|---|---|
| 30-day emergency presentations · reduced | 0.88 |
| ACS diagnosis and angiography in women (subgroup) · acute coronary syndrome (ACS) diagnosis in women, increased | 1.48 |
| ACS diagnosis and angiography in women (subgroup) · angiography in women, increased | 1.66 |
- Acute coronary syndrome (ACS) diagnosis and angiography in women (subgroup): multiplicative interactions were nominally significant but not after Holm correction
Costs
- lowered costs
- -€345
Safety
Deaths within 3 days among non-conveyed patients
- no deaths within 3 days among 1526 non-conveyed patients
- 1526
Original publication
PreHEART score for emergency medical services triage of chest pain: a randomised trial. Heart. Published 29 September 2026. doi:10.1136/heartjnl-2026-328924
Summarised from the published abstract; every number is checked against it