• G L Taylor, N F Murphy, C Berry, J Christie, A Finlayson, K MacIntyre, C Morrison, and J McMurray.
• Department of Cardiology, Western Infirmary, Glasgow, UK.
• Heart. 2008 May 1; 94 (5): 628-32.

ObjectiveTo examine the long-term outcome of patients evaluated in a rapid assessment chest pain clinic (RACPC): are "low-risk" patients safely reassured?DesignRetrospective cohort study.SettingStaff grade-led RACPC in an urban teaching hospital.Participants3378 patients (51% male), attending the RACPC between April 1996 and February 2000.Main Outcome MeasuresDeath, coronary mortality, morbidity and revascularisation over a median follow-up of 6 years. Coronary standardised mortality ratio (SMR).Results2036 (60.3%) patients were categorised as "low risk", 957 (28.3%) as having "stable coronary artery disease" and 214 (6.3%) as being an "acute coronary syndrome". During the study, 3.6% of patients in the low risk category, 11.9% in the stable coronary artery disease category and 24.6% in the acute coronary syndrome category died from coronary artery disease or had a myocardial infarction. 5.5%, 18.2% and 18.4%, respectively, died from any cause. Compared to the local population (coronary SMR = 100), our "low risk/non-coronary chest pain" cohort had a coronary SMR of 51 (95% CI 31 to 83), the "stable coronary artery disease" cohort 240 (187 to 308) and the "acute coronary syndrome" cohort 780 (509 to 1196).ConclusionThe RACPC was effective at triaging patients with chest pain. Patients identified as at "low risk" were unlikely to have an adverse coronary outcome and were appropriately reassured.

24 keywords...

hide…