Predictores de síndrome coronario agudo sin supradesnivel del ST y estratificación de riesgo en la unidad de dolor torácico. Experiencia en 1.168 pacientes / Predictors of acute coronary syndrome without ST segment elevation and risk stratification in the chest pain unit
Rev. méd. Chile
;
136(4): 442-450, abr. 2008. graf, tab
Article
in Spanish
| LILACS
| ID: lil-484919
ABSTRACT
Background:
Nearly 10 percent of patients with an actual acute coronary syndrome (ACS) are discharged with an inadequate diagnosis. Aim To select clinical and laboratory predictors to identify patients with a high likelihood of ACS in the Chest Pain Unit. Material andmethods:
Prospective evaluation of patients consulting in a Chest Pain Unit of a University Hospital. Initial assessment was standardized and included evaluation of pain characteristics, electrocardiogram and Troponin I. Independent predictors of ACS were identified with a multiple logistic regression.Results:
In a four years period, 1,168 patients aged 62±23 years (69 percent males), were studied. After initial evaluation, 62 percent of the patients were admitted to the hospital for further testing and in 71 percent of them, a definite diagnosis of ACS was made. No events were reported by patients directly discharged from the Chest Pain Unit. Independent predictors associated with a higher likelihood of ACS were an abnormal electrocardiogram at the initial evaluation (Odds ratio (OR) 5.37, 95 percent confidence intervals (CI) 3.61-7.99), two or more cardiovascular risk factors (OR 2.16, 95 percent CI 1.21-2.84), cervical irradiation of the pain (OR 1.84, 95 percent CI 1.25-2.69), age over 65years (OR 1.73, 95 percent CI (1.32-2.27) and a Troponin I above the upper normal limit (OR 5.68, 95 percent CI 3.72-8.29).Conclusions:
Simple clinical findings allow an appropriate identification of patients with a high likelihood of ACS without specialized methods for myocardial ischemia detection.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Chest Pain
/
Acute Coronary Syndrome
Type of study:
Etiology study
/
Observational study
/
Prognostic study
Limits:
Female
/
Humans
/
Male
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2008
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Pontificia Universidad Católica de Chile/CL
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