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Reducing unnecessary investigations in chest pain with state-of-the-art diagnostic cardiac techniques

University of Sydney

  • Cardiovascular Early-Mid Career Researcher Grant
Date Funded:
  • 18 November, 2021
Chief Investigator/s:
  • Dr. Rebecca Kozor

Project Summary

Reducing unnecessary investigations in chest pain with state-of-the-art diagnostic cardiac techniques.

What is the issue for NSW?

Chest pain is the most common presentation to adult emergency departments. Many patients undergo unnecessary hospital admissions and tests, especially invasive coronary angiograms, to distinguish the serious (heart attack) from non-serious causes. Two diagnostic techniques offer untapped potential in this setting in Australia – cardiovascular magnetic resonance (CMR) and advanced electrocardiography (A-ECG).

Novel research techniques using advanced computerised analysis on the traditional ECG, known as A-ECG. This research will assess A-ECG’s diagnostic performance and ability to influence downstream tests in chest pain. A-ECG could be used to avoid unnecessary tests and improve healthcare costs.

Despite the international evidence supporting CMR in diagnosing patients with chest pain, CMR is poorly utilised in Australia due to a lack of evidence specific to the Australian health system and no Medicare reimbursement. This research aims to provide strong evidence for the use and cost-effectiveness of CMR in chest pain and heart attack in Australia.

What does the research aim to do and how?

This research aims to relieve the growing burden of unnecessary hospital admissions and cardiac investigations, especially invasive coronary angiograms in Australia. This study aims to achieve this by delivering strong evidence of the diagnostic use and cost-effectiveness of A-ECG and CMR relative to the NSW healthcare setting.

Specifically, this study will validate the diagnostic and triaging utility of A-ECG in acute chest pain, and 1-year outcomes through a clinical trial at multiple sites. Study two and three will determine the clinical utility and cost-effectiveness of early CMR in suspected heart attack. This will be achieved through a pilot randomised clinical trial at one site.