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Master Thesis

Évaluation des pratiques de dosage de la troponine en cas de douleur thoracique, en soins primaires, au Pays basque

Abstract : Introduction: in 2010, the HAS established recommendations limiting the use of troponin in ambulatory medicine to restrictive indications. However, recourse to this dosage is frequent in general medicine. The main objective of our study was to investigate the factors that led general practitioners in the Basque Country to their last prescription of troponin, for chest pain. Materials and methods: our study was a quantitative, descriptive, retrospective study by straight questionnaire from 03/16/2020 to 09/13/2020. Results: 177 general practitioners were included in our study. The main factors leading to their last prescription of troponin were the patient's cardiovascular risk factors (54.9%, n=79), chest pain suspected of acute coronary syndrome but not typical (52.1%, n=75), the wish to avoid hospitalizing the patient directly in case of low suspicion of acute coronary syndrome (47.9%, n=69), the wish to reassure the patient fearing a cardiac etiology (27.8%, n=40) and the patient's cardiovascular history (24.3%, n=28). 89.5% of practitioners (n=28) prescribed this dosage to exclude the diagnosis of acute coronary syndrome. 40% of practitioners (n=70) knew the HAS recommendations. The frequency of troponin prescription increased with the age of the practitioners (p<0.001) and decreased with knowledge of the HAS recommendations (p=0.03). 43.4% of practitioners (n=76) had an ECG machine and 31% of practitioners (n=44) performed an ECG before prescribing this dosage. The nature of the troponin result conditioned the patient management (p<0.001). Conclusion: the majority of troponin dosages in our study were prescribed for pain atypical or little suspicion of acute coronary syndrome. Cardiovascular risk factors and the patients' cardiovascular history have led the majority of practitioners to prescribe this dosage in order to exclude the diagnosis of acute coronary syndrome.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03219585
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Submitted on : Thursday, May 6, 2021 - 3:04:29 PM
Last modification on : Thursday, July 8, 2021 - 3:16:00 AM
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Yassine Bennis. Évaluation des pratiques de dosage de la troponine en cas de douleur thoracique, en soins primaires, au Pays basque. Médecine humaine et pathologie. 2021. ⟨dumas-03219585⟩

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