[A new risk score for patients with a normal or non-diagnostic ECG admitted to a chest pain unit].
OBJECTIVE
Patients admitted to chest pain units are usually classified on the basis of the results of non-invasive tests. However, the large number of potential patients places a strain on limited resources. Our aim was to identify clinical variables that may help determining the risk of coronary artery disease.


METHODS
We studied 365 consecutive patients admitted to the chest pain unit at our institution, all of whom had an ECG that did not show significant changes in repolarization.


RESULTS
The patients' mean age was 62.3 years. Independent predictors of coronary artery disease were: typical chest pain, aspirin use, diabetes, and age >64 years. A risk score obtained by combining these 4 factors was related to the occurrence of a clinical event during the patient's stay in the chest pain unit, to coronary artery disease prevalence (which varied from 3.9% in those with a score of 0 to 66.7% in those with a score of 4), to all-cause mortality, and to the development of acute coronary syndrome during the 6-month follow-up period.


CONCLUSIONS
The presence of typical chest pain, aspirin use, diabetes, and an age >64 years is associated with an increased probability of coronary artery disease in patients admitted to chest pain units. A risk score obtained by combining these four factors may be clinically useful and help optimizing resource management.
Martínez-Sellés
Manuel
M
Servicio de Cardiología, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Ortiz
Javier
J
Estévez
Alvaro
A
Andueza
Juan
J
de Miguel
José
J
Bueno
Héctor
H
D000367:Age Factors; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D002637:Chest Pain / Q000175:diagnosis; D003327:Coronary Disease / Q000175:diagnosis* / Q000453:epidemiology; D003627:Data Interpretation, Statistical; D048909:Diabetes Complications; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006757:Hospital Units; D006801:Humans; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D013997:Time Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010975:Platelet Aggregation Inhibitors; D001241:Aspirin