title: The Internet Tracking Registry of Acute Coronary Syndromes (i*trACS): a multicenter registry of patients with suspicion of acute coronary syndromes reported using the standardized reporting guidelines for emergency department chest pain studies.
abstract: OBJECTIVE
  Observational studies of well-described patient populations presenting to emergency departments (EDs) with suspicion of acute coronary syndrome are necessary to understand the relationships between patients' signs and symptoms, cardiac risk profile, test results, practice patterns, and outcomes. We describe the methods for data collection and the ED population enrolled in a multicenter registry of patients with chest pain.
  
  
  METHODS
  Patients older than 18 years, presenting to one of 8 EDs in the United States or 1 ED in Singapore, and with possible acute coronary syndrome were enrolled in the Internet Tracking Registry of Acute Coronary Syndromes between June 1999 and August 2001. Prospective data, including presenting signs and symptoms, ECG findings, and the ED physician's initial impression of risk, were systematically collected. Medical record review or daily follow-up was used to obtain cardiac biomarker results, invasive and noninvasive testing, treatments, procedures, and inhospital outcomes. Thirty-day outcomes were determined by telephone follow-up and medical record review.
  
  
  RESULTS
  The registry includes 15,608 patients, with 17,713 visits. Chest pain was the chief complaint in 71% of visits. The ECG was diagnostic of ischemia or infarction in 10.1% and positive cardiac biomarkers were observed in 10% of visits. Forty-three percent of patients were sent home directly from the ED. Of admitted patients, 5% died by 30 days, and 3% had documented coronary artery disease or had undergone percutaneous coronary intervention or coronary artery bypass grafting within 30 days. For patients discharged directly from the ED, 0.4% died or had a documented myocardial infarction within 30 days. Coronary artery bypass graft surgery, percutaneous coronary intervention, or a diagnosis of coronary artery disease was found in 0.5% of discharged patients.
  
  
  CONCLUSIONS
  A unique description of undifferentiated ED chest pain patients with suspected acute coronary syndrome is provided. The data set can be used to generate and explore hypotheses to improve understanding of the complex relationships between presentation, treatment, testing, intervention and outcomes.
authors.affiliation: Department of Emergency Medicine, University of Cincinnati Medical Center, Cincinnati, OH 45267-0769, USA. christopher.lindsell@uc.edu
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Lindsell
authors.forename: Venkataraman
authors.initials: V
authors.lastname: Anantharaman
authors.forename: Deborah
authors.initials: D
authors.lastname: Diercks
authors.forename: Jin Ho
authors.initials: JH
authors.lastname: Han
authors.forename: James W
authors.initials: JW
authors.lastname: Hoekstra
authors.forename: Judd E
authors.initials: JE
authors.lastname: Hollander
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Kirk
authors.forename: Swee-Han
authors.initials: SH
authors.lastname: Lim
authors.forename: W Frank
authors.initials: WF
authors.lastname: Peacock
authors.forename: Brian
authors.initials: B
authors.lastname: Tiffany
authors.forename: Eric K
authors.initials: EK
authors.lastname: Wilke
authors.forename: W Brian
authors.initials: WB
authors.lastname: Gibler
authors.forename: Charles V
authors.initials: CV
authors.lastname: Pollack
mesh_terms: D015415:Biomarkers; D002637:Chest Pain / Q000097:blood / Q000175:diagnosis; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020407:Internet; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis; D012042:Registries; D012846:Singapore / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
chemical_list: D015415:Biomarkers