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- W4387337811 abstract "HEART score is widely used for risk stratification of chest pain in the emergency department (ED). Current guidelines recommend discharging patients with low-risk heart score (LRHS) as the expected future cardiac events are low. However, there is controversy in the management plan with the increasing evidence of non-negligible cardiac events among LRHS patients. In this study we aim to investigate the value of downstream non-invasive stress imaging test (NISI) in predicting cardiac events in patients with LRHS. We prospectively included 1384 patients with LRHS between 2019 to 2021. All patients underwent NISI (myocardial perfusion imaging or stress echocardiography). Primary endpoints were: Cardiac deaths, nonfatal myocardial infarctions, and significant coronary stenosis. Secondary endpoints define as cardiovascular-related admission or ED visit. The mean age was 64±14 years, 670 (48.4%) were women. During the follow-up period of 634±104 days, 58/1384 (4.2%) patients developed 62 primary endpoints and 60 (4.3%) patients developed secondary endpoints. Multivariable cox models adjusted to clinical and imaging variables which showed that diabetes (Hazard ratio (HR): 2.38; 95% CI: 1.25-4.49, P=0.008), HEART score of 3 (HR: 1.32; 95% CI 0.83- 1.89; P=0.01 ), prior history of CAD had HR of 2.75 (95% CI: 1.40-5.41; P=0.003), ECG changes (HR: 5.11; 95% CI: 2.61-10.01; P< 0.0001), and abnormal NISI (HR:16.4; 95% CI: 9.56-28.03; P< 0.0001) in predicting primary endpoints, In contrast, abnormal NISI was the sole predictor of secondary endpoints with (HR:3.05; 95% CI: 1.31-7.14; P< 0.0001). NISI significantly predict primary cardiac events and cardiovascular-related readmission/ED visits in patients with LRHS." @default.
- W4387337811 created "2023-10-05" @default.
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- W4387337811 date "2023-10-01" @default.
- W4387337811 modified "2023-10-06" @default.
- W4387337811 title "UTILITY OF DOWNSTREAM STRESS TEST IMAGING FOR RISK STRATIFICATION OF PATIENTS PRESENTING TO EMERGENCY DEPARTMENT WITH CHEST PAIN AND LOW HEART SCORE." @default.
- W4387337811 doi "https://doi.org/10.1016/j.cjca.2023.06.381" @default.
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