Outcomes in patients with chest pain evaluated in a chest pain unit: The chest pain evaluation in the emergency room study cohort

Michael W. Cullen, Guy S. Reeder, Michael E. Farkouh, Stephen L. Kopecky, Peter A. Smars, Thomas R. Behrenbeck, Thomas G. Allison

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Background: Limited data exist on the long-term outcomes of patients who undergo evaluation in a chest pain unit (CPU). Methods: Our study included patients with chest pain at intermediate risk for acute cardiovascular events enrolled in the CHEER study. The primary outcome included a composite of death, myocardial infarction, acute heart failure, stroke, and out-of-hospital cardiac arrest. The secondary outcome included a composite of cardiovascular death, myocardial infarction, acute heart failure, stroke, revascularization, and unstable angina. Data were obtained through a medical record review. We compared outcomes between groups randomized to the CPU versus admission, those admitted from the CPU versus dismissed home, and those who were admitted versus dismissed home after a cardiac stress test in the emergency department. Results: The final analysis included 407 patients. Median surveillance length was 5.5 years. No differences in the primary outcome or secondary outcome existed between patients randomized to the CPU versus admitted to hospital (21.6% vs 20.2% and 29.9% vs 33.0%, respectively, P > .05 for all comparisons). Patients admitted from the CPU had higher rates of the secondary outcome (adjusted hazard ratio 2.26) than patients dismissed from the CPU. Patients admitted after a cardiac stress test in the CPU had higher rates of the secondary outcome (adjusted hazard ratio 2.42) than patients dismissed from the CPU. Conclusions: A CPU does not increase long-term adverse outcomes in patients with chest pain at intermediate risk for an acute event.

Original languageEnglish (US)
Pages (from-to)871-877
Number of pages7
JournalAmerican Heart Journal
Volume161
Issue number5
DOIs
StatePublished - May 2011

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Chest Pain
Hospital Emergency Service
Cohort Studies
Exercise Test
Heart Failure
Stroke
Myocardial Infarction
Out-of-Hospital Cardiac Arrest
Unstable Angina
Medical Records

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Cullen, M. W., Reeder, G. S., Farkouh, M. E., Kopecky, S. L., Smars, P. A., Behrenbeck, T. R., & Allison, T. G. (2011). Outcomes in patients with chest pain evaluated in a chest pain unit: The chest pain evaluation in the emergency room study cohort. American Heart Journal, 161(5), 871-877. https://doi.org/10.1016/j.ahj.2011.02.008

Outcomes in patients with chest pain evaluated in a chest pain unit : The chest pain evaluation in the emergency room study cohort. / Cullen, Michael W.; Reeder, Guy S.; Farkouh, Michael E.; Kopecky, Stephen L.; Smars, Peter A.; Behrenbeck, Thomas R.; Allison, Thomas G.

In: American Heart Journal, Vol. 161, No. 5, 05.2011, p. 871-877.

Research output: Contribution to journalArticle

Cullen, MW, Reeder, GS, Farkouh, ME, Kopecky, SL, Smars, PA, Behrenbeck, TR & Allison, TG 2011, 'Outcomes in patients with chest pain evaluated in a chest pain unit: The chest pain evaluation in the emergency room study cohort', American Heart Journal, vol. 161, no. 5, pp. 871-877. https://doi.org/10.1016/j.ahj.2011.02.008
Cullen, Michael W. ; Reeder, Guy S. ; Farkouh, Michael E. ; Kopecky, Stephen L. ; Smars, Peter A. ; Behrenbeck, Thomas R. ; Allison, Thomas G. / Outcomes in patients with chest pain evaluated in a chest pain unit : The chest pain evaluation in the emergency room study cohort. In: American Heart Journal. 2011 ; Vol. 161, No. 5. pp. 871-877.
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