A simple score for predicting coronary artery disease in patients with chest pain.
BACKGROUND
We have previously derived a chest pain score by comparing those with and without coronary artery disease on angiography, which was subsequently validated in patients attending coronary angiography.


OBJECTIVE
To test the predictive validity of the score prospectively in a more varied out-patient population, and to determine whether it had predictive validity in addition to exercise testing.


METHODS
Prospective clinical study.


METHODS
The score was applied to 405 out-patients with chest pain who subsequently underwent coronary angiography. Framingham risk analysis and exercise testing were performed in 155.


RESULTS
The score had a sensitivity of 91.4% and specificity of 28% for coronary artery disease, which was found in 31.8%, 51%, 63%, and 82% of those with scores of 0, 1, 2, and 3, respectively. Gender (p < 0.001), age (p < 0.001), and chest pain score (p = 0.009) independently predicted coronary artery disease on multivariate Poisson regression analysis. The chest pain score had additive predictive value with Framingham risk analysis and Duke's score.


CONCLUSIONS
This simple chest pain score can predict coronary anatomy with similar sensitivity to exercise testing, and can be used in conjunction with exercise testing and other measures. Further validation of the chest pain score in the primary care setting will be useful.
Wu
E B
EB
Cardiothoracic Centre, Guy's and St Thomas' Hospitals, London, UK.ebwu@netvigator.com
Hodson
F
F
Chambers
J B
JB
D000368:Aged; D002637:Chest Pain / Q000209:etiology*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis*; D005080:Exercise Test / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity