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Cardiac (non-arrest)
Prehospital ACS risk stratification: the evidence
Contemporary Approaches to Prehospital Acute Coronary Syndrome Risk Stratification: A Narrative Review
Clinical and Experimental Emergency Medicine · 2026-10-15 · Added 17 October 2026
A narrative review of prehospital ACS risk stratification found HEART-derived pathways combined with point-of-care troponin carry the strongest evidence for safe field risk assessment, while AI-assisted ECG interpretation remains promising but prospectively unvalidated.
- Study type
- Other
- Design
- Narrative review
- Participants
- Literature 2020–2025 plus grey literature and citation review
- Main finding
- Biomarker-integrated pathways (HEART-derived approaches with point-of-care troponin) showed the strongest evidence for safe prehospital risk assessment; ECG transmission remains foundational for STEMI activation and AI decision-support lacks prospective outcome-based validation.
- Caveat
- Narrative rather than systematic — no protocol, formal search strategy or quality appraisal.
- Bottom line
- Context only
Why it matters in Australia (High relevance). Prehospital ECG acquisition and chest-pain triage pathways are standard across Australian services, so the review's map of what works — and what's still unproven — reads directly onto local practice.
Learning goal
Weigh the role of biomarker-integrated pathways and point-of-care troponin against ECG-based assessment in prehospital ACS risk stratification.
More
- Topic: Cardiac (non-arrest)
- Daily scan: 17 October 2026
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