title: A chest pain score for stratifying the risk of coronary artery disease in patients having day case coronary angiography.
abstract: 'Typical' or 'atypical' are universally used descriptions of chest pain, but they are limited by subjectivity. This study tested the ability of a semi-objective chest pain score to predict the likelihood of coronary disease. A chest pain questionnaire was given to 250 patients with stable chest pain attending coronary angiography. The answers to three questions were defined as 'typical' or 'atypical' and summed to give a 'typical' score between 0 and 3. Logit analysis was performed based on an age cut-off of 55 years and 'typical' score. There were 96 (38%) patients with normal coronary arteries and 154 (62%) with coronary disease. In patients aged under 55 years, the likelihood of coronary disease by 'typical' score was 11% (score 0), 30% (score 1), 40% (score 2), 53% (score 3). Similar figures for age 55 years were 39% (score 0), 45% (score 1), 77% (score 2), and 85% (score 3). There is a direct relationship between 'typical' chest pain score and the likelihood of coronary artery disease. This scoring system may be useful in the clinical characterization of patients for research, for guiding referral to a cardiologist or for aiding the decision to perform coronary angiography.
authors.affiliation: Cardiothoracic Centre, Guy's and St Thomas' Hospitals, London, UK. e_wu@hotmail.com
authors.forename: E B
authors.initials: EB
authors.lastname: Wu
authors.forename: N
authors.initials: N
authors.lastname: Smeeton
authors.forename: J B
authors.initials: JB
authors.lastname: Chambers
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000175:diagnosis*; D017023:Coronary Angiography; D003327:Coronary Disease / Q000453:epidemiology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010147:Pain Measurement / Q000379:methods*; D015203:Reproducibility of Results; D012306:Risk; D018709:Statistics, Nonparametric