title: Prevalence, etiology and outcome of catheterization laboratory false alarms in patients with suspected ST-elevation myocardial infarction.
abstract: OBJECTIVE
  To investigate the prevalence, causes and outcome of catheterization laboratory false alarms (CLFAs) in a regional primary angioplasty network.
  
  
  METHODS
  A prospective registry of 1,662 patients referred for primary angioplasty between January 2003 and August 2008 was reviewed to identify CLFAs (i.e. when no culprit coronary lesion could be found).
  
  
  RESULTS
  No culprit coronary lesion could be identified in 120 patients (7.2%; 95% confidence interval [CI], 5.9-8.5%). Of these, 104 (6.3%, 95% CI, 5.1-7.4%) had a discharge diagnosis other than ST-elevation myocardial infarction, 91 (5.5%; 95% CI, 4.3-6.6%) had no significant coronary disease, and 64 (3.8%; 95% CI, 2.9-4.8%) tested negative for cardiac biomarkers. The most frequent alternative diagnoses were: previous Q-wave myocardial infarction (18 cases), nonspecific ST-segment abnormalities (11), pericarditis (10) and transient apical dyskinesia (10). The 30-day mortality rate was similar in patients with and without culprit lesions (5.8% vs. 5.8%; P=.99). The prevalence of CLFAs was slightly higher in patients not previously evaluated by a cardiologist and referred from emergency departments in hospitals without catheterization laboratories than in those referred by cardiologists from emergency departments at hospitals with such facilities (9.5% vs. 6.1%; P=.02; odds ratio=1.64; 95% CI, 1.08-2.5). The prevalence of CLFAs was not significantly higher in patients referred by physicians with out-of-hospital emergency medical services (7.2%; P=.51; odds ratio=1.37; 95% CI, 0.79-2.37).
  
  
  CONCLUSIONS
  The prevalence of CLFAs was 7.2%, with the criterion of no culprit coronary lesion. Our findings suggest that different patterns of referral to catheterization laboratories could account for small variations in the prevalence of CLFAs.
authors.affiliation: Complejo Hospitalario Universitario de A Coruña, Spain. blargesbueno@hotmail.com
authors.forename: Eduardo
authors.initials: E
authors.lastname: Barge-Caballero
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Vázquez-Rodríguez
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Estévez-Loureiro
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Barge-Caballero
authors.forename: Alejandro
authors.initials: A
authors.lastname: Rodríguez-Vilela
authors.forename: Ramón
authors.initials: R
authors.lastname: Calviño-Santos
authors.forename: Jorge
authors.initials: J
authors.lastname: Salgado-Fernández
authors.forename: Guillermo
authors.initials: G
authors.lastname: Aldama-López
authors.forename: Pablo
authors.initials: P
authors.lastname: Piñón-Esteban
authors.forename: Rosa
authors.initials: R
authors.lastname: Campo-Pérez
authors.forename: José Angel
authors.initials: JA
authors.lastname: Rodríguez-Fernández
authors.forename: Nicolás
authors.initials: N
authors.lastname: Vázquez-González
authors.forename: Javier
authors.initials: J
authors.lastname: Muñiz-García
authors.forename: Alfonso
authors.initials: A
authors.lastname: Castro-Beiras
mesh_terms: D000368:Aged; D017130:Angioplasty; D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization / Q000009:adverse effects*; D006348:Cardiac Surgical Procedures; D017023:Coronary Angiography; D004562:Electrocardiography; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology*