American Journal of Cardiology
Volume 97, Issue 5 , Pages 633-635 , 1 March 2006

Usefulness of Early Exercise Testing and Clinical Risk Score for Prognostic Evaluation in Chest Pain Units Without Preexisting Evidence of Myocardial Ischemia

  • Juan Sanchis, MD

      Affiliations

    • Servei de Cardiologia, Hospital Clínic Universitari, València, Spain
    • Corresponding Author InformationCorresponding author: Tel/fax: 34-963-862-658.
    • ,
  • Vicent Bodí, MD

      Affiliations

    • Servei de Cardiologia, Hospital Clínic Universitari, València, Spain
    • ,
  • Julio Núñez, MD

      Affiliations

    • Servei de Cardiologia, Hospital Clínic Universitari, València, Spain
    • ,
  • Vicente Bertomeu-González, MD

      Affiliations

    • Servei de Cardiologia, Hospital Clínic Universitari, València, Spain
    • ,
  • Cristina Gómez

      Affiliations

    • Servei de Cardiologia, Hospital Clínic Universitari, València, Spain
    • ,
  • Luciano Consuegra, MD

      Affiliations

    • Servei de Cardiologia, Hospital Clínic Universitari, València, Spain
    • ,
  • María José Bosch, MD

      Affiliations

    • Servei de Cardiologia, Hospital Clínic Universitari, València, Spain
    • ,
  • Xavier Bosch, MD

      Affiliations

    • Institut Clínic de Malalties Cardiovasculars, Hospital Clínic, Barcelona, Spain
    • ,
  • Francisco Javier Chorro, MD

      Affiliations

    • Servei de Cardiologia, Hospital Clínic Universitari, València, Spain
    • ,
  • Angel Llácer, MD

      Affiliations

    • Servei de Cardiologia, Hospital Clínic Universitari, València, Spain

Received 5 August 2005 ,Revised 16 September 2005 ,Accepted 16 September 2005.

References 

  1. Sanchis J, Bodí V, Llácer A, Núñez J, Consuegra L, Bosch MJ, et al. Risk stratification of patients with acute chest pain and normal troponin concentrations . Heart . 2005;91:1013–1018
  2. Sanchis J, Bodí V, Llácer A, Facila L, Núñez J, Roselló A, et al. Predictors of short-term outcome in acute chest pain without ST-segment elevation . Int J Cardiol . 2003;92:193–199
  3. Sanchis J, Bodí V, Llácer A, Facila L, Pellicer M, Bertomeu V, et al. Emergency room risk stratification of patients with chest pain without ST-segment elevation . Rev Esp Cardiol . 2003;56:955–962
  4. Sanchis J, Bodí V, Núñez J, Bertomeu-González V, Gómez C, Bosch MJ, et al. New risk score for patients with acute chest pain, non–ST-segment deviation and normal troponin concentrations (a comparison with the TIMI risk score) . J Am Coll Cardiol . 2005;46:443–449
  5. Sanchis J, Bodí V, Llácer A, Facila L, Núñez J, Bertomeu V, et al. Usefulness of concomitant myoglobin and troponin elevation as biochemical marker of mortality in non–ST-segment elevation acute coronary syndromes . Am J Cardiol . 2003;91:13–16
  6. Bodí V, Sanchis J, Llácer A, Facila L, Núñez J, Pellicer M, et al. Multimarker risk strategy for predicting 1-month and 1-year major events in non–ST-elevation acute coronary syndromes . Am Heart J . 2005;149:268–274
  7. Geleijnse ML, Elhendy A, Kasprzak JD, Rambaldi R, Van Domburg RT, Cornel JH, et al. Safety and prognostic value of early dobutamine-atropine stress echocardiography in patients with spontaneous chest pain and a non-diagnostic electrocardiogram . Eur Heart J . 2000;21:397–406
  8. Lewis WR , Amsterdam EA . Utility and safety of immediate exercise testing of low-risk patients admitted to the hospital for suspected acute myocardial infarction . Am J Cardiol . 1994;74:987–990
  9. Farkouh ME, Smars PA, Reeder GS, Zinsmeister AR, Evans RW, Meloy TD, et al. A clinical trial of a chest-pain observation unit for patients with unstable angina . N Eng J Med . 1998;339:1882–1888
  10. Kirk JD , Turnipseed S , Lewis WR , Amsterdam EA . Evaluation of chest pain in low-risk patients presenting to the emergency department (the role of immediate exercise testing) . Ann Emerg Med . 1998;32:1–7
  11. Polancyk CA , Johnson PA , Hartley H , Walls RM , Shaykevich S , Lee T . Clinical correlates and prognostic significance of early negative exercise tolerance test in patients with acute chest pain seen in the hospital emergency department . Am J Cardiol . 1998;81:288–292
  12. Lewis WR , Amsterdam EA , Turnipseed S , Kirk JD . Immediate exercise testing of low risk patients with known coronary artery disease presenting to the emergency department with chest pain . J Am Coll Cardiol . 1999;33:1843–1847
  13. Diercks DB , Gibler B , Liu T , Sayre MR , Storrow AB . Identification of patients at risk by graded exercise testing in an emergency department chest pain center . Am J Cardiol . 2000;86:289–292
  14. DeFilippi CR, Rosanio S, Tocchi M, Parmar RJ, Potter MA, Uretsky BF, et al. Randomized comparison of a strategy of predischarge coronary angiography versus exercise testing in low-risk patients in a chest pain-unit (in-hospital and long-term outcomes) . J Am Coll Cardiol . 2001;37:2042–2049
  15. Amsterdam EA , Kirk JD , Diercks DB , Lewis WR , Turnipseed SD . Immediate exercise testing to evaluate low-risk patients presenting to the emergency department with chest pain . J Am Coll Cardiol . 2002;40:251–256
  16. Pastor Torres L , Pavón Jiménez R , Reina Sánchez M , Caparrós Valderrama J , Mora Pardo J . Chest pain unit (one-year follow-up) . Rev Esp Cardiol . 2002;55:1021–1027
  17. Sanchis J , Bodí V , Llácer A , Núñez J , Ferrero JA , Chorro FJ . Exercise testing in a chest pain unit . Rev Esp Cardiol . 2002;55:1089–1092
  18. Kerns JR , Shaub TF , Fontanarosa PB . Emergency cardiac stress testing in the evaluation of emergency patients with atypical chest pain . Ann Emerg Med . 1993;22:794–798
  19. Gomez MA , Anderson JL , Karagounis LA , Muhlestein JB , Mooers FB . An emergency department-based protocol for rapidly ruling out myocardial ischemia reduces hospital time and expense (results of a randomized study (ROMIO)) . J Am Coll Cardiol . 1996;28:25–33
  20. Ramakrishna G, Zinsmeister AR, Farkouh ME, Evans RW, Allison TG, Smars PA, et al. Effect of exercise treadmill testing and stress imaging on the triage of patients with chest pain (CHEER substudy) . Mayo Clin Proc . 2005;80:322–329

 This work was supported by a grant from Instituto de Salud Carlos III, Spanish Public Health Care System.

PII: S0002-9149(05)01995-8

doi: 10.1016/j.amjcard.2005.09.107

American Journal of Cardiology
Volume 97, Issue 5 , Pages 633-635 , 1 March 2006

Article Tools

* Image Usage & Resolution