Positive non-invasive tests in the chest pain unit: importance of the clinical profile for estimating the probability of coronary artery disease.
We studied 100 consecutive patients with coronary angiography performed after a positive result of a non-invasive test in the chest pain unit. Mean age was 66 years. The percentage of patients without significant coronary artery disease, 1-vessel disease and multivessel disease was 35, 33, and 32%, respectively. The CPU-65 index that combines four clinical variables (comorbidity: diabetes, pain: typical, use of: aspirin, 65 years old or more) was associated with the presence of coronary artery disease, multivessel disease, and coronary revascularization. We conclude that in the chest pain unit, patients with a positive non-invasive test the rate of false positive results, one-vessel disease and multivessel disease is similar. However, important changes in these percentages are seen, according to the clinical profile. The CPU-65 index is useful to determine the pre-test probability of significant coronary artery disease and patients with intermediate scores are the ones that benefit most of non-invasive tests.
Martinez-Selles
Manuel
M
Departments of Cardiology and Emergency Medicine, Hospital Universitario "Gregorio Maranon", Madrid, Spain. mmselles@secardiologia.es
Bueno
Hector
H
Estevez
Alvaro
A
De Miguel
Jose
J
Munoz
Javier
J
Fernandez-Aviles
Francisco
F
D000367:Age Factors; D000368:Aged; D002637:Chest Pain / Q000209:etiology*; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000175:diagnosis*; D003327:Coronary Disease / Q000000981:diagnostic imaging*; D003920:Diabetes Mellitus; D003935:Diagnostic Techniques, Cardiovascular; D004452:Echocardiography; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain; D018570:Risk Assessment