[Chest pain unit: one-year follow-up].
OBJECTIVE
In Spain there is little information available about chest pain units for the treatment of patients of low-to-medium risk with suspected acute coronary syndrome.


METHODS
A prospective study was performed among emergency room patients who complained about acute chest pain and were suspected of suffering an acute coronary syndrome with a normal or unspecific initial evaluation. They underwent an early submaximum stress test to decide on possible hospitalization. The follow-up time was 1 year.


RESULTS
Of 472 emergency room patients with suspected acute coronary syndrome, 179 performed the stress-test during the first hours of the triggering chest pain episode. None met the high-risk criteria for unstable angina. In 78.8% of the cases, the test results were negative and the patients were discharged. The results were positive in 15.1% and inconclusive in 6.1%; there were no complications during the procedure. Patients with a negative stress test had a more favorable outcome than the rest, with fewer following visits to the emergency room (11% vs 22%, p<0.001). One patient with a negative stress test died of a non-cardiovascular complication. None of the patients suffered acute myocardial infarction during follow-up and 89% of the patients with negative stress test had a favorable outcome (in terms of visits to the emergency room, unstable angina, acute myocardial infarction, or cardiovascular death).


CONCLUSIONS
Chest pain units for the care of low-to-medium risk patients with acute chest pain allow a fast and safe hospital release with a favorable mid-term outcome.
Pastor Torres
Luis F
LF
Servicio de Cardiología. Hospital Universitario Virgen de Valme. Sevilla. España. lpastortorres@eresmas.com
Pavón-Jiménez
Ricardo
R
Reina Sánchez
Margarita
M
Caparros Valderrama
Jorge
J
Mora Pardo
José A
JA
D000328:Adult; D000367:Age Factors; D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis*; D002637:Chest Pain; D016009:Chi-Square Distribution; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006757:Hospital Units; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D011446:Prospective Studies; D012306:Risk; D012737:Sex Factors; D016019:Survival Analysis; D013997:Time Factors