Taylor, GL and Murphy, NF and Berry, C and Christie, J and Finlayson, A and Macintyre, K and Morrison, C and McMurray, JJV, Long-term outcome of low-risk patients attending a rapid-assessment chest pain clinic, Heart, 94, (5) pp. 628-632. ISSN 1355-6037 (2008) [Refereed Article]
DESIGN: Retrospective cohort study.
SETTING: Staff grade-led RACPC in an urban teaching hospital.
PARTICIPANTS: 3378 patients (51% male), attending the RACPC between April 1996 and February 2000.
MAIN OUTCOME MEASURES: Death, coronary mortality, morbidity and revascularisation over a median follow-up of 6 years. Coronary standardised mortality ratio (SMR).
RESULTS: 2036 (60.3%) patients were categorised as "low risk", 957 (28.3%) as having "stable coronary artery disease" and 214 (6.3%) as being an "acute coronary syndrome". During the study, 3.6% of patients in the low risk category, 11.9% in the stable coronary artery disease category and 24.6% in the acute coronary syndrome category died from coronary artery disease or had a myocardial infarction. 5.5%, 18.2% and 18.4%, respectively, died from any cause. Compared to the local population (coronary SMR = 100), our "low risk/non-coronary chest pain" cohort had a coronary SMR of 51 (95% CI 31 to 83), the "stable coronary artery disease" cohort 240 (187 to 308) and the "acute coronary syndrome" cohort 780 (509 to 1196).
CONCLUSION: The RACPC was effective at triaging patients with chest pain. Patients identified as at "low risk" were unlikely to have an adverse coronary outcome and were appropriately reassured.
|Item Type:||Refereed Article|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Cardiovascular medicine and haematology|
|Research Field:||Cardiology (incl. cardiovascular diseases)|
|Objective Group:||Clinical health|
|Objective Field:||Clinical health not elsewhere classified|
|UTAS Author:||Macintyre, K (Dr Kate Macintyre)|
|Web of Science® Times Cited:||19|
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