Key result
Women presenting with chest pain who were classified as low risk had a 30-day coronary artery disease rate of 1.3%, with no coronary events occurring.
Why the study?
Is functional diagnostic testing necessary to identify coronary artery disease in low-risk women presenting with chest pain?
Observational (n=1,355)
Is functional diagnostic testing necessary to identify coronary artery disease in low-risk women presenting with chest pain?
Women admitted to a chest pain evaluation unit who are identified as low risk have a very low rate of CAD (1.3%) and no short-term coronary events, suggesting routine functional testing may be unnecessary.
Answers are grounded in this paper and cite their sources.
Low event rates support considering deferred testing in low-risk women; hypothesis-generating and requires prospective validation before practice change.
OBJECTIVE: The objective of this study was to assess the need for functional diagnostic testing to identify coronary artery disease (CAD) in women presenting with chest pain and deemed at low risk in a chest pain evaluation unit (CPEU) setting. METHODS: Low-risk women evaluated in a CPEU were defined as having < or =1 intermediate determinant of CAD (hypertension, tobacco use, or hypercholesterolemia) or < or =2 minor determinants (age, obesity, sedentary lifestyle, or family history of CAD). Patients were followed for 30 days for the occurrence of CAD, defined as a positive stress imaging study, significant CAD on angiography, myocardial revascularization, myocardial infarction (MI), or cardiac death. RESULTS: Of 1355 consecutive women evaluated, 527 (39%) were classified as low risk. The rate of CAD in the low-risk group was 1.3% of which there were no coronary events. CONCLUSION: Women admitted to a CPEU and identified as low risk are at very low risk for CAD.
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Diercks et al. (2006) conducted an observational in Chest pain (n=1,355). Low clinical risk for CAD was evaluated on Occurrence of CAD (positive stress imaging study, significant CAD on angiography, myocardial revascularization, MI, or cardiac death). Women presenting with chest pain who were classified as low risk had a 30-day coronary artery disease rate of 1.3%, with no coronary events occurring.
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