Risk and cardiac biomarkers in prehospital acute coronary syndrome: A scoping review

Background: Research into prehospital risk mitigation using clinical risk scores in conjunction with biomarker analysis is lacking. Aims: This research aimed to identify the extent, range and nature of literature surrounding clinical risk in acute coronary syndrome and adverse cardiac events within the prehospital setting. Methods: This study applied the JBI scoping review methodology to identify peer-reviewed scientific literature published from January 2000 to August 2022. Articles were obtained from searches of two electronic databases, CINAHL Plus and MEDLINE (Ovid). The search results were filtered and selected for analysis through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) statement. Results: The initial search yielded a total of 234 results. Of these, 154 were screened resulting in a final total of 10 articles from which clinical risk scores and prehospital cardiac biomarkers were highlighted for discussion. Conclusion: Clinical risk scores provide practitioners with a foundation for risk analysis when assessing a patient with suspected acute coronary syndrome. The most effective risk-score method to predict major adverse cardiac events was the HEART score. Technological advances in biomarker analysis may assist when used in conjunction with risk scores.