| Exercise tolerance as a predictor of acute myocardial infarction in emergency department patients with potential acute coronary syndromes. | |
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MedLine Citation:
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PMID: 17933479 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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There is mounting evidence that exercise tolerance is an important predictor of heart disease. Our objective was to determine if decreased exercise tolerance, as estimated by physicians, may be useful in stratifying risk in Emergency Department (ED) patients with potential acute coronary syndromes. We conducted a prospective cohort study on a convenience sample of ED patients at an urban teaching hospital. Patients with chest pain, dyspnea, syncope, or epigastric pain who were evaluated for acute coronary syndromes were included. Clinical and laboratory data were recorded. In addition, the Emergency Physicians were asked to estimate the exercise tolerance of the patient as excellent, good, bad, or very poor. The primary outcome of the study was myocardial infarction (MI) or death in patients stratified by physician-perceived exercise tolerance (excellent or good vs. bad or very poor). There were 166 patients enrolled in the study. Nine patients (5%) had an MI; there were no deaths. Physicians reported exercise tolerance as excellent in 33 patients, good in 63, bad in 50, and very poor in 20. The unadjusted risk of MI was significantly elevated in patients with physician-perceived decreased exercise tolerance (relative risk = 4.8, 95% confidence interval 1.03-22). After adjustment for age, sex, and major cardiovascular risk factors, decreased exercise tolerance remained a significant predictor of MI (adjusted odds ratio = 7.3, 95% confidence interval 1.2-46). Exercise tolerance, as estimated by clinical impression, may be an important predictor of complications in ED patients presenting with potential acute coronary syndromes. |
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Authors:
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Siu Fai Li; Kristine Samson; Maureen Bell; Wendy Whiteside; Michaella Okihara; Jonathan Prince; Veronica Kheyfets; Stephen Wall |
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Publication Detail:
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Type: Evaluation Studies; Journal Article Date: 2007-10-15 |
Journal Detail:
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Title: The Journal of emergency medicine Volume: 36 ISSN: 0736-4679 ISO Abbreviation: J Emerg Med Publication Date: 2009 Jan |
Date Detail:
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Created Date: 2009-01-26 Completed Date: 2009-05-04 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8412174 Medline TA: J Emerg Med Country: United States |
Other Details:
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Languages: eng Pagination: 8-11 Citation Subset: IM |
Affiliation:
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Department of Emergency Medicine, Jacobi Medical Center, Bronx, New York 10461, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Acute Coronary Syndrome
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diagnosis* Adult Aged Emergency Service, Hospital* Exercise Tolerance* Female Humans Male Middle Aged Myocardial Infarction / diagnosis* Odds Ratio Pilot Projects Predictive Value of Tests Prospective Studies Risk Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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