Validation of an Accelerated Diagnostic Protocol for Aboriginal and Torres Strait Islander Patients with Suspected Acute Coronary Syndrome

Introduction: Aboriginal and Torres Strait Islander (ATSI) people have a high burden of cardiovascular disease. Observed rates of major coronary events are seven to nine times higher in people aged < 45 years for this population when compared with non-Indigenous Australians. The Improved Assessment of Chest Pain Trial (ImpACT) protocol is an evidenced-based ADP, which combines sensitive troponin testing, objective testing and clinical criteria, including age, to identify patients at high, intermediate or low risk of acute coronary syndrome (ACS). The Accelerated Chest Pain Risk Evaluation (ACRE) project is currently implementing the ImpACT protocol into public hospitals across Queensland. Aboriginal and Torres Strait Islander patients were under-represented in the original ImpACT study.

Purpose: To determine if the ImpACT protocol should be altered for the assessment of ATSI patients who present to an emergency department (ED) with suspected ACS.

Methods: The ImpACT ATSI study is a single-centre, prospective, observational trial being conducted in partnership with the Queensland Health Clinical Excellence Division and the Australian Centre for Health Services Innovation (AusHSI). Aboriginal and Torres Strait Islander patients who present with symptoms of suspected ACS are prospectively recruited and managed according to intermediate or high-risk pathways, including objective testing for coronary artery disease. 30-follow-up with cardiologist adjudication of events is occurring.

Outcomes: To date, 67 patients have been recruited into the trial and the authors look forward to sharing the preliminary findings of the research.