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June 17, 1974JAMA

Prognosis in coronary care unit noninfarction cases

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Population

169 patients with chest pain admitted to the Stanford University Hospital coronary care unit to rule out a…

Design

Cohort

Follow-up

average 17.9 months

Authors

MLMário G. LopesEscola Bahiana de Medicina e Saúde Pública

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Implication

High post-discharge cardiac mortality in non-MI patients with ST-T changes; leaves open whether targeted surveillance improves survival.

Key Points

  • Determine the long-term prognosis and incidence of cardiac death in patients admitted to a coronary care unit with chest pain and ST-T abnormalities who did not experience an acute myocardial infarction.
  • Follow-up study of 169 patients admitted to a coronary care unit with chest pain to rule out myocardial infarction, followed for an average of 17.9 months.
  • Inclusion criteria required electrocardiographic ST-T abnormalities in the absence of acute infarction, verified by lack of new Q waves and serial enzyme determinations.
  • Post-discharge cardiac mortality was 4.2% at one month, 10.1% at one year, and 19.7% at two years.
  • Sudden death accounted for 43% of the total cardiac deaths during the follow-up period.

Structured PICO

P
Population
169 patients with chest pain admitted to the Stanford University Hospital coronary care unit to rule out a myocardial infarction, with electrocardiographic ST-T abnormalities in the absence of infarction (no new Q waves or serial enzyme determinations).
O
Outcome
Subsequent cardiac death following discharge from the coronary care unithard clinical

Patients with chest pain and ST-T abnormalities but no confirmed MI have a high risk of subsequent cardiac death, warranting more aggressive evaluation and follow-up.

Cite This Study

Mário G. Lopes (1974) studied this question.

synapsesocial.com/papers/6a72c18735aa2c282ce36a64https://doi.org/10.1001/jama.228.12.1558
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Also Consider

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

  1. 1Patients treated in a coronary care unit without acute myocardial infarction: identification of high risk subgroup for subsequent myocardial infarction and/or cardiovascular death.1979 · 42 citations
  2. 2Do Patients in Whom Myocardial Infarction Has Been Ruled out Have a Better Prognosis after Hospitalization Than Those Surviving Infarction?1980 · 123 citations
  3. 3Long Term Prognosis Following Treatment in a Coronary-Care Unit1973 · 19 citations
  4. 4The Elderly Patient in the Coronary Care Unit: III. Factors Affecting Long‐term Prognosis1983 · 1 citations
  5. 5Six year follow up of a consecutive series of patients presenting to the coronary care unit with acute chest pain: prognostic importance of the electrocardiogram.1990 · 12 citations