What does this research mean for the field?

In patients admitted with acute chest pain but without confirmed myocardial infarction, long-term risk of cardiac events can be independently predicted by age, abnormal resting ECG, low increase in rate pressure product, multiform premature ventricular beats, and transient thallium defects. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To identify long-term risk factors for cardiac events and angina pectoris in patients hospitalized with acute chest pain without confirmed acute myocardial infarction.

January 1, 1995European Heart Journal

Long-term risk factors from non-invasive evaluation of patients with acute chest pain, but without myocardial infarction

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Why the study?

What are the long-term risk factors for cardiac events in patients admitted with acute chest pain but without confirmed AMI?

Population

257 consecutive patients admitted with acute chest pain, but without confirmed AMI, without other severe…

Design

Cohort

Follow-up

7 years

Authors

JLJ LaunbjergCardiac Imaging PFP FruergaardUniversity College Capital HJHenrik Loft JacobsenHerlev Hospital

Discussion

Member takes

Implication

ECG and thallium findings may stratify risk after chest-pain rule-out; leaves open prospective validation before guiding management.

Key Points

To identify long-term risk factors for cardiac events and angina pectoris in patients hospitalized with acute chest pain without confirmed acute myocardial infarction.
Followed a prospective cohort of 257 consecutive non-infarction patients aged under 76 years for 7 years.
Assessed clinical history, exercise electrocardiography, Holter monitoring, thallium scintigraphy, echocardiography, and chest radiography at baseline.
Performed univariate and multivariate analyses to determine independent predictors of cardiac death, non-fatal myocardial infarction, and angina.
Over the 7-year follow-up, 69 cardiac events occurred, comprising 44 cardiac deaths and 25 non-fatal acute myocardial infarctions.
Independent risk factors for cardiac events included low increase in rate pressure product (relative risk [RR] 4.57, 95% CI 2.21–9.44), abnormal resting ECG (RR 2.81, 95% CI 1.33–5.90), transient thallium defects (RR 2.64, 95% CI 1.33–5.24), multiform premature ventricular beats (RR 2.61, 95% CI 1.34–5.09), and age (RR 1.05, 95% CI 1.01–1.09).
Development of angina pectoris in patients without previous coronary artery disease could not be predicted by any baseline non-invasive variables.

Structured PICO

What are the long-term risk factors for cardiac events in patients admitted with acute chest pain but without confirmed AMI?

Population

257 consecutive patients admitted with acute chest pain, but without confirmed AMI (non-AMI), without other severe disease and below 76 years of age

Outcome

Cardiac events (cardiac death and non-fatal acute myocardial infarction) and development of angina pectoriscomposite

Resting and exercise ECG, along with other non-invasive tests, can effectively risk-stratify patients presenting with acute chest pain who rule out for myocardial infarction.

Cite This Study

Launbjerg et al. (1995) studied this question.

synapsesocial.com/papers/6a1bf7c000ee29383e9d3c01 https://doi.org/10.1093/eurheartj/16.1.30

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Long-term risk factors from non-invasive evaluation of patients with acute chest pain, but without myocardial infarction

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Long-term risk factors from non-invasive evaluation of patients with acute chest pain, but without myocardial infarction

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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