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November 19, 2008Cardiology

Long-Term Risk of Death, Cardiac Events and Recurrent Chest Pain in Patients with Acute Chest Pain of Different Origin

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Why the study?

What is the long-term prognosis and risk of cardiac events in patients presenting with acute non-AMI chest pain of different origins?

Population

204 patients with acute chest pain of different origin, but without myocardial infarction (non-AMI).

Design

Cohort

Follow-up

33 months

Authors

JLJ LaunbjergCardiac ImagingPFP FruergaardUniversity College CapitalBHBirger HesseCopenhagen University Hospital

Discussion

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Implication

Ischaemic heart disease marks high cardiac event risk in non-AMI chest pain; leaves open whether targeted strategies improve outcomes.

Key Points

  • To determine the long-term risk of adverse cardiac events, mortality, and recurrent chest pain in patients presenting with acute chest pain without acute myocardial infarction.
  • Evaluated 204 patients admitted with acute chest pain excluding acute myocardial infarction, using non-invasive cardiac and systemic diagnostic testing for 148 patients without an immediate diagnosis within 24–48 hours.
  • Tracked patients over a 33-month follow-up period to document cardiac events (cardiac death, non-fatal myocardial infarction, bypass surgery, or angioplasty), hospital readmissions, and recurrent pain.
  • Ischaemic heart disease (IHD) was identified in 64 patients, gastro-oesophageal disorders in 81, and chest wall disorders in 58.
  • Cardiac events occurred in 31 of 64 patients with IHD compared to only 3 of 140 patients without IHD (p < 0.00001) over 33 months.
  • Rates of hospital readmission and recurrent episodes of chest pain did not differ significantly across the three major diagnostic groups.

Structured PICO

What is the long-term prognosis and risk of cardiac events in patients presenting with acute non-AMI chest pain of different origins?

P
Population
204 patients with acute chest pain of different origin, but without myocardial infarction (non-AMI).
I
Intervention
Diagnostic workup including non-invasive cardiac and non-cardiac examinations
O
Outcome
Cardiac events (composite of cardiac deaths, non-fatal AMI, bypass surgery or PTCA)composite

Non-invasive cardiac examination can successfully identify a high-risk subset of patients with non-AMI acute chest pain, though morbidity remains high across all diagnostic groups due to frequent readmissions and recurrent pain.

Cite This Study

Launbjerg et al. (2008) studied this question.

synapsesocial.com/papers/6a6f71d8e71d69abee080442https://doi.org/10.1159/000177061

Topics

Women and heart disease
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The diagnoses of patients admitted with acute chest pain but without myocardial infarction1996 · 150 citations
  2. 2Long-term risk factors from non-invasive evaluation of patients with acute chest pain, but without myocardial infarction1995 · 14 citations
  3. 3One-Stop Chest Pain Clinic Can Identify High Cardiac Risk1997 · 25 citations
  4. 4Chest pain without established ischaemic heart disease in primary care patients: associated comorbidities and mortality2009 · 43 citations
  5. 5Prognosis of undiagnosed chest pain: linked electronic health record cohort study2017 · 59 citations