TY - JOUR
T1 - Prognosis of Low-Risk Young Women Presenting to the Emergency Department with Chest Pain
AU - Stauber, Stacey M.
AU - Teleten, Aleksander
AU - Li, Zhongmin
AU - Venugopal, Sandhya
AU - Amsterdam, Ezra A
PY - 2016/1/1
Y1 - 2016/1/1
N2 - Identification of patients at low risk presenting to the emergency department with chest pain is a continuing challenge. We examined a cohort of low-risk women with negative cardiac injury markers, electrocardiogram with normal results, and clinical stability. We hypothesized that these patients can be safely and accurately managed in a chest pain unit (CPU), may not require predischarge cardiac testing, and have an excellent short-term prognosis. The primary end point was major cardiovascular events during index admission or follow-up. Mean age of the 403 women was 42 ± 4.3 years (30 to 50 years). No patient had a cardiovascular event in the CPU, and none of the 321 patients followed for 6 months had a late cardiovascular event. Most (211, 52%) did not receive predischarge cardiac testing. The remaining 192 patients (48%) had predischarge exercise treadmill test, stress imaging, or cardiac catheterization. Of those patients who underwent treadmill testing, almost 90% had no exercise-induced chest pain and approximately 50% had functional capacity 8 to 14 METs. In addition, 166 patients (41%) were discharged from the CPU after <2 hours and 21% (n = 86) within 2 to 8 hours. In conclusion, this group of low-risk women was safely and accurately managed in the CPU and discharged promptly. There were no cardiac events on index admission or 6-month follow-up, and in most patients, predischarge cardiac testing was unnecessary.
AB - Identification of patients at low risk presenting to the emergency department with chest pain is a continuing challenge. We examined a cohort of low-risk women with negative cardiac injury markers, electrocardiogram with normal results, and clinical stability. We hypothesized that these patients can be safely and accurately managed in a chest pain unit (CPU), may not require predischarge cardiac testing, and have an excellent short-term prognosis. The primary end point was major cardiovascular events during index admission or follow-up. Mean age of the 403 women was 42 ± 4.3 years (30 to 50 years). No patient had a cardiovascular event in the CPU, and none of the 321 patients followed for 6 months had a late cardiovascular event. Most (211, 52%) did not receive predischarge cardiac testing. The remaining 192 patients (48%) had predischarge exercise treadmill test, stress imaging, or cardiac catheterization. Of those patients who underwent treadmill testing, almost 90% had no exercise-induced chest pain and approximately 50% had functional capacity 8 to 14 METs. In addition, 166 patients (41%) were discharged from the CPU after <2 hours and 21% (n = 86) within 2 to 8 hours. In conclusion, this group of low-risk women was safely and accurately managed in the CPU and discharged promptly. There were no cardiac events on index admission or 6-month follow-up, and in most patients, predischarge cardiac testing was unnecessary.
UR - http://www.scopus.com/inward/record.url?scp=84959193665&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84959193665&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2015.09.045
DO - 10.1016/j.amjcard.2015.09.045
M3 - Article
C2 - 26552512
AN - SCOPUS:84959193665
VL - 117
SP - 36
EP - 39
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 1
ER -