Negative ECG-gated cardiac CT in patients with low-to-moderate risk chest pain in the emergency department: 1-year follow-up.

Negative ECG-gated cardiac CT in patients with low-to-moderate risk chest pain in the emergency department: 1-year follow-up.

MedLine Citation:	PMID: 20858819 Owner: NLM Status: MEDLINE
Abstract/OtherAbstract:	OBJECTIVE: The purpose of this article is to determine the frequency of adverse cardiac events during the year following a negative cardiac CT angiogram in a population of patients presenting to the emergency department with low-to-moderate risk chest pain. SUBJECTS AND METHODS: Eighty-one consecutive patients who had standard of care evaluation for low-to-moderate risk chest pain in the emergency department were enrolled and consented to have a cardiac CT angiogram added to their workup and to have follow-up for 1 year. Eleven patients were excluded, six because their cardiac CT examinations were unsuccessful, four because of a positive cardiac CT angiogram result, and one was lost to follow-up. Seventy patients with negative cardiac CT angiographic results (< 50% stenosis) were included and were interviewed in detail at 3, 6, and 12 months about intervening cardiac events, diagnostic testing, and therapy. Electronic medical records were also reviewed at each time point. RESULTS: None of the 70 patients reported an adverse cardiac event over the 12-month follow-up period. At 1 year, the cause of chest pain was unknown in 49 patients, gastrointestinal in nine patients, anxiety in seven patients, musculoskeletal in three patients, and other in two patients. Three of four patients with 50% or greater stenosis on their cardiac CT had subsequent cardiac catheterization and stent placement. CONCLUSION: In patients with low-to-moderate risk chest pain evaluated in the emergency department, adverse cardiac events may be rare during the 12 months following a negative cardiac CT angiogram.

Authors:	William P Shuman; Janet M May; Kelley R Branch; Lee M Mitsumori; Jared N Strote; Douglas E Green; James H Caldwell
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Publication Detail:	Type: Journal Article; Research Support, Non-U.S. Gov't
Journal Detail:	Title: AJR. American journal of roentgenology Volume: 195 ISSN: 1546-3141 ISO Abbreviation: AJR Am J Roentgenol Publication Date: 2010 Oct
Date Detail:	Created Date: 2010-09-22 Completed Date: 2010-10-29 Revised Date: 2011-05-10
Medline Journal Info:	Nlm Unique ID: 7708173 Medline TA: AJR Am J Roentgenol Country: United States
Other Details:	Languages: eng Pagination: 923-7 Citation Subset: AIM; IM
Affiliation:	Department of Radiology, University of Washington School of Medicine, Seattle, WA 98195, USA. wshuman@u.washington.edu
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MeSH Terms
Descriptor/Qualifier:	Chest Pain / diagnosis* Electrocardiography* Emergency Service, Hospital Female Follow-Up Studies Heart Diseases / diagnosis, epidemiology Humans Male Middle Aged Prospective Studies Risk Factors Time Factors Tomography, X-Ray Computed*
Grant Support
ID/Acronym/Agency:	KL2 RR025015-03/RR/NCRR NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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