TCT-1202 Impact of Emergency Physician-Performed Point-of-Care Echocardiography in Acute Coronary Syndrome Presentations: Long-Term Clinical Outcomes

Document Type

Abstract

Publication Date

10-28-2025

Abstract

Background: Point-of-care echocardiography (POCUS) performed by emergency physicians is increasingly utilized for early risk stratification in acute coronary syndrome (ACS). However, the impact of early POCUS use on long-term outcomes remains poorly defined. This study evaluates whether routine use of POCUS in the emergency department (ED) for ACS patients improves long-term cardiovascular outcomes compared to standard evaluation without POCUS. Methods: We conducted a prospective, multicenter cohort study including 3,720 ACS patients presenting to the ED across 12 institutions. Patients were stratified into two groups: those who received POCUS by trained emergency physicians during the initial ER evaluation (n=1,864) and those who underwent standard clinical assessment without POCUS (n=1,856). The primary endpoint was incidence of major adverse cardiovascular events (MACE) at 12 months. Secondary endpoints included time to diagnosis, in-hospital mortality, need for advanced mechanical support, and 30-day readmission. Results: Patients in the POCUS group had significantly lower rates of MACE at 12 months (11.8% vs 15.4%, p=0.003), in-hospital mortality (2.2% vs 3.6%, p=0.02), and need for mechanical circulatory support (2.5% vs 4.1%, p=0.01) compared to the control group. The median time to confirmed diagnosis was also shorter in the POCUS group (41 min vs 63 min, p< 0.001), suggesting earlier triage and more appropriate risk stratification. There was a modest but significant reduction in 30-day readmission (6.5% vs 8.2%, p=0.04). Conclusion: Emergency physician-performed point-of-care echocardiography (POCUS) in patients presenting with acute coronary syndrome significantly improves long-term clinical outcomes, including reduced rates of MACE, in-hospital mortality, and mechanical circulatory support utilization. Additionally, POCUS use is associated with faster diagnosis and reduced early readmission rates. These findings support the integration of POCUS into routine emergency department evaluation of ACS patients as a valuable tool for early risk stratification and timely clinical decision-making. Categories: CORONARY: Acute Coronary Syndromes

Publication Title

Journal of the American College of Cardiology

Volume

86

Issue

17 Supplement

First Page

B514

Last Page

B515

Comments

Transcatheter Cardiovascular Therapeutics held 2025-10-25 to 2025-10-28 in San Francisco, CA

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