| Coronary artery disease in patients with chest pain who have low-risk clinical characteristics and negative cardiac troponin I. | |
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MedLine Citation:
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PMID: 11239254 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Patients who have low-risk clinical features and negative cardiac troponin levels may be suitable for early discharge after a brief period of observation in the emergency department (ED). Little is known about the prevalence and severity of coronary artery disease in such patients, although this has implications for follow-up. Subjects included 570 patients who were at < or =7% risk of acute myocardial infarction (AMI), remained clinically stable (defined as the absence of new ischemic changes on their electrocardiograph, signs or symptoms of heart failure, the development of a cardiac arrhythmia or hypotension requiring either inotropes or volume repletion) and had cardiac troponin I (cTnI) levels <0.2 microgl(-1) during the initial 12 hours of hospitalization. Clinical features were documented and those undergoing stress tests and/or coronary angiograms had these graded by 2 independent observers. Overall, 190 (33.3%) of this population, who might be considered suitable for early discharge, had objective evidence of coronary artery disease. Patients with chest pain who are at low risk of AMI, remain clinically stable and have negative cTnI over the initial 12 hours of observation are a heterogeneous population, some of who have threatening coronary disease. This does not preclude early discharge from the ED but emphasizes the need for careful assessment and follow-up. |
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Authors:
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G S Hillis; C Oliner; B J O'Neil; V Pansuriya; P Taggart; N Zhao; W C Dalsey; A Mangione |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: The American journal of emergency medicine Volume: 19 ISSN: 0735-6757 ISO Abbreviation: Am J Emerg Med Publication Date: 2001 Mar |
Date Detail:
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Created Date: 2001-03-12 Completed Date: 2001-04-05 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8309942 Medline TA: Am J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 118-21 Citation Subset: IM |
Affiliation:
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Department of Emergency Medicine, Albert Einstein Medical Center, Philadelphia, PA, USA. grahamhillis@hotmail.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Chest Pain / diagnosis* Coronary Angiography Coronary Disease / epidemiology Electrocardiography Emergency Service, Hospital* Exercise Test Female Humans Male Michigan / epidemiology Middle Aged Myocardial Infarction / diagnosis*, epidemiology Myocardium / metabolism Patient Discharge* Philadelphia / epidemiology Prevalence Prognosis Risk Troponin I / metabolism |
| Chemical | |
Reg. No./Substance:
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0/Troponin I |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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