Clinically relevant adverse cardiovascular events in intermediate heart score patients admitted to the hospital following a negative emergency department evaluation - 29/07/21
, Mark Sutherland, MD b, Robert Brown, MD b, Akilesh Honasoge, MD c, Michael Witting, MD, MS dAbstract |
Study hypothesis |
Study objective: To estimate the frequency of clinically relevant adverse cardiac events (CRACE) in patients admitted to the hospital for chest pain with an intermediate HEART score (4, 5, 6), non-diagnostic EKG, and a negative initial troponin.
Methods |
We conducted a retrospective analysis of all patients admitted to the University of Maryland Medical Center (UMMC) from May 2016 to May 2019 with an intermediate HEART score (4, 5, or 6), a non-diagnostic EKG, and a negative initial troponin. Our primary outcome was the rate of inpatient clinically relevant adverse cardiac events (CRACE), composite of life-threatening dysrhythmia, inpatient STEMI, cardiac or respiratory arrest, and all-cause mortality during hospitalization.
Results |
A total of 1118 patients met our inclusion criteria, 6 of whom had CRACE. Overall the rate of CRACE was 0.5% (95% CI, 0.2–1.2%). Six patients (0.5%, 95% CI, 0.2%–1.2%) experienced inpatient NSTEMIs, 212 patients (19%, 95% CI, 17–21%) underwent provocative testing during their inpatient stay, 5 patients received a stent or CABG, and 5 patients had false positive non-invasive testing and underwent a negative cardiac catheterization.
Conclusions |
In this cohort of admitted patients with a documented intermediate-risk HEART score, nonischemic EKG, and negative initial troponin, the occurrence of CRACE during the index hospitalization was 0.5%.
Le texte complet de cet article est disponible en PDF.Keywords : Acute coronary syndrome, The HEART score
Plan
Vol 46
P. 469-475 - août 2021 Retour au numéro
Article précédent
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