Assessing the need for functional diagnostic testing in low-risk women with chest pain.
OBJECTIVE
The objective of this study was to assess the need for functional diagnostic testing to identify coronary artery disease (CAD) in women presenting with chest pain and deemed at low risk in a chest pain evaluation unit (CPEU) setting.


METHODS
Low-risk women evaluated in a CPEU were defined as having < or =1 intermediate determinant of CAD (hypertension, tobacco use, or hypercholesterolemia) or < or =2 minor determinants (age, obesity, sedentary lifestyle, or family history of CAD). Patients were followed for 30 days for the occurrence of CAD, defined as a positive stress imaging study, significant CAD on angiography, myocardial revascularization, myocardial infarction (MI), or cardiac death.


RESULTS
Of 1355 consecutive women evaluated, 527 (39%) were classified as low risk. The rate of CAD in the low-risk group was 1.3% of which there were no coronary events.


CONCLUSIONS
Women admitted to a CPEU and identified as low risk are at very low risk for CAD.
Diercks
Deborah B
DB
Division of Emergency Medicine, Department of Internal Medicine, University of California, Davis, School of Medicine, Sacramento, California 95817, USA. dbdiercks@ucdavis.edu
Kirk
J Douglas
JD
Turnipseed
Samuel D
SD
Amsterdam
Ezra A
EA