Key result
Outpatient cardiology referrals carry a low ~3% long-term MACE rate, enabling symptom-based risk stratification.
Why the study?
With an increasing burden of cardiovascular disease and rising demand for outpatient cardiology services, referral patterns from primary care and longer term clinical outcomes based on symptomatology and risk stratification needed evaluation.
Does risk stratification based on referral symptomatology predict long-term adverse clinical outcomes in stable outpatients referred to cardiology?
Population
33,244 consecutive outpatients referred from primary care to a national cardiac centre without known CAD
Comparison
Risk stratification by pre-test probability of obstructive CAD (chest pain) or age and sex (other symptoms)
Design
Cohort study
Follow-up
3 years
Authors
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May support risk-based triage of low-risk referrals; extends pre-test probability models with real-world outcome data.
Cohort (n=33,244)
No
Does risk stratification based on referral symptomatology predict long-term adverse clinical outcomes in stable outpatients referred to cardiology?
Risk stratification of stable outpatients referred to cardiology can identify low-risk subsets with very low 3-year rates of mortality and MACE, potentially reducing the need for incremental testing.
Chua et al. (2025) conducted a cohort in Outpatient cardiology referrals (n=33,244). Cardiology referral for chest pain, palpitations, or dyspnoea was evaluated on Mortality and major adverse cardiovascular events (MACE). Among 33,244 outpatients referred to cardiology, 3-year mortality and MACE rates were low (e.g., 1.25% and 3.19% for chest pain, respectively), and risk stratification identified lower-risk subsets.
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