Chest pain is one of the most common reasons people present to the emergency department. While it can signal a heart attack, symptoms frequently have other causes, such as heartburn, lung conditions, or musculoskeletal complaints affecting the spine and surrounding muscles.
The challenge lies in ruling out a heart attack as quickly and reliably as possible. The sooner this can be done, the sooner patients can be discharged from the emergency department.
The ACS Pathfinder is designed to support doctors in making this decision. The web-based tool uses machine learning, combining the cardiac biomarker troponin with clinical information such as age, heart rate and ECG findings to calculate an individual's probability of having had a heart attack. Preliminary work on the method was also supported by the DZHK. Its development and validation were based on data from more than 27,000 patients across nine countries.
No heart attack – faster discharge
In previous studies, the ACS Pathfinder was already able to rule out a heart attack with confidence in significantly more people after just a single troponin measurement: on average 36 per cent, compared with 14 per cent using the established comparator method.
"This means that, in future, considerably more patients could receive early certainty and be discharged from the emergency department sooner. For them, this means fewer further investigations and shorter waiting times," says Professor Johannes Neumann of UKE, co-inventor and co-principal investigator of the study. At the same time, hospitals could save costs, and clinical staff would have more time for patients who urgently need treatment.
DZHK study to test use in the emergency department
Whether the approach also proves its worth in routine clinical practice is now being examined in the DZHK-funded CHASE-MI-DZHK33 study. In the emergency departments of six participating centres, 658 patients with a clinical suspicion of heart attack will be randomly assigned to be assessed either using current standard care or with the additional support of the ACS Pathfinder. The researchers will examine how many patients can be safely discharged from the emergency department after just a single troponin measurement.
"These study results are important for assessing the efficiency, safety and ultimately the benefit of the ACS Pathfinder in real-world clinical use," says Professor Raphael Twerenbold of UKE, also a co-inventor and co-principal investigator of the study. The study is scheduled to begin at the end of 2026.
To further develop the tool for clinical use, the researchers founded ART-EMIS Hamburg GmbH, a UKE spin-off, in 2023. The ACS Pathfinder has now received CE certification as a Class IIb medical device, and a European patent was also granted in September 2026.
Pathfinder online:
acs-pathfinder.com
app.acs-pathfinder.com
Scientific contact:
Prof. Johannes Neumann, Universitätsklinikum Hamburg-Eppendorf, jo.neumann@uke.de
