title: Quick identification of acute chest pain patients study (QICS).
abstract: BACKGROUND
  Patients with acute chest pain are often referred to the emergency ward and extensively investigated. Investigations are costly and could induce unnecessary complications, especially with invasive diagnostics. Nevertheless, chest pain patients have high mortalities. Fast identification of high-risk patients is crucial. Therefore several strategies have been developed including specific symptoms, signs, laboratory measurements, and imaging.
  
  
  METHODS
  The Quick Identification of acute Chest pain Study (QICS) will investigate whether a combined use of specific symptoms and signs, electrocardiography, routine and new laboratory measures, adjunctive imaging including electron beam (EBT) computed tomography (CT) and contrast multislice CT (MSCT) will have a high diagnostic yield for patients with acute chest pain. All patients will be investigated according a standardized protocol in the Emergency Department. Serum and plasma will be frozen for future analysis for a wide range of biomarkers at a later time point. The primary endpoint is the safe recognition of low-risk chest pain patients directly at presentation. Secondary endpoint is the identification of a wide range of sensitive predictive clinical markers, chemical biomarkers and radiological markers in acute chest pain patients. Chemical biomarkers will be compared to quantitative CT measurements of coronary atherosclerosis as a surrogate endpoint. Chemical biomarkers will also be compared in head to head comparison and for their additional value.
  
  
  CONCLUSIONS
  This will be a very extensive investigation of a wide range of risk predictors in acute chest pain patients. New reliable fast and cheap diagnostic algorithm resulting from the test results might improve chest pain patients' prognosis, and reduce unnecessary costs and diagnostic complications.
authors.affiliation: Department of Cardiology, University Medical Center, Groningen, The Netherlands. h.m.willemsen@thorax.umcg.nl
authors.forename: Hendrik M
authors.initials: HM
authors.lastname: Willemsen
authors.forename: Gonda
authors.initials: G
authors.lastname: de Jong
authors.forename: René A
authors.initials: RA
authors.lastname: Tio
authors.forename: Wybe
authors.initials: W
authors.lastname: Nieuwland
authors.forename: Ido P
authors.initials: IP
authors.lastname: Kema
authors.forename: Iwan C C
authors.initials: IC
authors.lastname: van der Horst
authors.forename: Mattijs
authors.initials: M
authors.lastname: Oudkerk
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
mesh_terms: D015415:Biomarkers / Q000032:analysis; D002637:Chest Pain / Q000175:diagnosis* / Q000000981:diagnostic imaging; D004562:Electrocardiography; D006801:Humans; D007511:Ischemia / Q000175:diagnosis; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D015415:Biomarkers