Document Detail

Usefulness of early exercise testing and clinical risk score for prognostic evaluation in chest pain units without preexisting evidence of myocardial ischemia.
MedLine Citation:
PMID:  16490427     Owner:  NLM     Status:  MEDLINE    
We investigated whether the result of early exercise testing yields prognostic information in addition to that afforded by a clinical risk score in patients who present with chest pain in the emergency department. The study group consisted of 340 patients without preexisting evidence of myocardial ischemia. A clinical risk score was calculated. Primary (mortality or myocardial infarction) and secondary (mortality, myocardial infarction, or rehospitalization due to unstable angina) end points at 1 year were defined. Patients with a positive exercise test result underwent invasive management. Frequencies of primary (7.4% vs 2.1%, p = 0.06) and secondary (9.3% vs 2.8%, p = 0.04) end points and risk score (1.6 +/- 1.0 vs 1.0 +/- 0.9 points, p = 0.0001) were higher in patients with a positive exercise test result. However, in multivariate analysis, clinical risk score was the only independent predictor for the primary (hazard ratio 2.0, 95% confidence interval 1.2 to 3.2, p = 0.004) and secondary (hazard ratio 1.9, 95% confidence interval 1.2 to 2.9, p = 0.003) end points. In conclusion, if a policy of invasive management is implemented for patients with positive exercise test results, the clinical risk score constitutes the main prognostic predictor of 1-year outcome.
Juan Sanchis; Vicent Bodí; Julio Núñez; Vicente Bertomeu-González; Cristina Gómez; Luciano Consuegra; María José Bosch; Xavier Bosch; Francisco Javier Chorro; Angel Llácer
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't     Date:  2006-01-06
Journal Detail:
Title:  The American journal of cardiology     Volume:  97     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2006 Mar 
Date Detail:
Created Date:  2006-02-21     Completed Date:  2006-04-18     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  633-5     Citation Subset:  AIM; IM    
Servei de Cardiologia, Hospital Clínic Universitari, València, Spain.
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MeSH Terms
Angina Pectoris / diagnosis*,  etiology
Chest Pain / etiology*
Diagnosis, Differential
Emergency Medical Services*
Endpoint Determination
Exercise Test*
Follow-Up Studies
Middle Aged
Multivariate Analysis
Myocardial Ischemia / complications,  diagnosis*
Odds Ratio
Predictive Value of Tests
Proportional Hazards Models
Risk Assessment
Risk Factors
Survival Analysis
Time Factors

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

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