Care Models for Acute Chest Pain That Improve Outcomes and Efficiency: JACC State-of-the-Art Review.

Existing assessment pathways for acute chest pain are often resource-intensive, prolonged, and expensive. In this review, the authors describe existing chest pain pathways and current issues at the patient and system level, and provide an overview of recent advances in chest pain research that could inform improved outcomes for both patients and health systems. There are multiple avenues to improve existing models of chest pain care, including novel risk stratification pathways incorporating highly sensitive point-of-care troponin assays; new devices available before first medical contact that could allow clinicians to access vital signs and electrocardiogram data; artificial intelligence and precision medicine tools that may guide indications for further testing; and strategies to improve hospital benchmarking and performance monitoring to standardize care. Improving the speed and accuracy of chest pain diagnosis and management should be a priority for researchers and is likely to translate to substantive benefits for patients and health systems.

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Copyright © 2022 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Funding Support and Author Disclosures Dr Dawson is supported by National Health and Medical Research Council of Australia (NHMRC) and National Heart Foundation (NHF) postgraduate scholarships. Dr Nehme is supported by an NHMRC/NHF early career fellowship. Dr Stub is supported by an NHF Fellowship (#105793). Dr Taylor is supported by an NHMRC Investigator grant. The authors have reported that they have no relationships relevant to the contents of this paper to disclose.