0

<< Identifying Emergency Department Patients With Chest Pain Who Are at Low Risk for Acute Coronary Syndromes

References

TOC Will Appear Here

References

References

Evidence-based medicine requires a critical appraisal of the literature based upon study methodology and number of subjects. Not all references are equally robust. The findings of a large, prospective, randomized, and blinded trial should carry more weight than a case report.

To help the reader judge the strength of each reference, pertinent information about the study is included in bold type following the reference, where available. In addition, the most informative references cited in this paper, as determined by the author, are noted by an asterisk (*) next to the number of the reference.

  1. Bhuiya FA, Pitts SR, McCaig LF. Emergency department visits for chest pain and abdominal pain: United States, 1999-2008. NCHS Data Brief. 2010;(43)(43):1-8. (Consensus report)
  2. * Amsterdam EA, Kirk JD, Bluemke DA, et al. Testing of low-risk patients presenting to the emergency department with chest pain: a scientific statement from the American Heart Association. Circulation. 2010;122(17):1756-1776. (Consensus statement)
  3. Welsford M, Nikolaou NI, Beygui F, et al. Part 5: acute coronary syndromes. 2015 international consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations. Circulation. 2015;132(16 Suppl 1):S146-S176. (Consensus guideline)
  4. * Thygesen K, Alpert JS, Jaffe AS, et al. Third universal definition of myocardial infarction. Circulation. 2012;126(16):2020-2035. (Consensus statement)
  5. * O’Connor RE, Al Ali AS, Brady WJ, et al. Part 9: acute coronary syndromes. 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015;132(18 Suppl 2):S483-S500. (Consensus guideline)
  6. * Amsterdam EA, Wenger NK, Brindis RG, et al. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2014;64(24):e139-e228. (Consensus guideline)
  7. Chew DP, Aroney CN, Aylward PE, et al. 2011 addendum to the National Heart Foundation of Australia/Cardiac Society of Australia and New Zealand guidelines for the management of acute coronary syndromes (ACS) 2006. Heart Lung Circ. 2011;20(8):487-502. (Consensus guideline)
  8. Roffi M, Patrono C, Collet J, et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2016;37(3):267-315. (Consensus guideline)
  9. Pope J, Aufderheide T, Ruthazer R, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med. 2000;342(16):1163-1170. (Prospective; 10,689 patients)
  10. Schull MJ, Vermeulen MJ, Stukel TA. The risk of missed diagnosis of acute myocardial infarction associated with emergency department volume. Ann Emerg Med. 2006;48(6):647-655. (Retrospective; 19,663 patients)
  11. Montassier E, Batard E, Gueffet JP, et al. Outcome of chest pain patients discharged from a French emergency department: a 60-day prospective study. J Emerg Med. 2012;42(3):341-344. (Prospective; 322 patients)
  12. Wilson M, Welch J, Schuur J, et a. Hospital and emergency department factors associated with variations in missed diagnosis and costs for patients age 65 years and older with acute myocardial infarction who present to emergency departments. Acad Emerg Med. 2014;21(10):1101-1108. (Retrospective; 371,638 patients)
  13. Rosen SD. From heart to brain: the genesis and processing of cardiac pain. Can J Cardiol. 2012;28(2):S7-S19. (Review)
  14. Lenfant C. Chest pain of cardiac and noncardiac origin. Metab Clin Exp. 2010;59 (Suppl 1):S41-S46. (Review)
  15. Di Carli M, Czernin J, Hoh C, et al. Relation among stenosis severity, myocardial blood-flow, and flow reserve in patients with coronary-artery disease. Circulation. 1995;91(7):1944-1951. (Prospective observational; 28 patients)
  16. Pursnani A, Chou ET, Zakroysky P, et al. Use of coronary artery calcium scanning beyond coronary computed tomographic angiography in the emergency department evaluation for acute chest pain: the ROMICAT II trial. Circ Cardiovasc Imaging. 2015;8:e002225. (Secondary analysis of a randomized controlled trial; 473 patients)
  17. Al-Zaiti SS, Callaway CW, Kozik TM, et al. Clinical utility of ventricular repolarization dispersion for real-time detection of non-ST elevation myocardial infarction in emergency departments. J Am Heart Assoc. 2015;4(7):e002057. (Secondary analysis of prospective study; 369 patients)
  18. Al-Zaiti SS, Martin-Gill C, Sejdic E, et al. Rationale, development, and implementation of the electrocardiographic methods for the prehospital identification of non-ST elevation myocardial infarction events (EMPIRE). J Electrocardiol. 2015;48(6):921-926. (Prospective observational, ongoing study; 261 patients in preliminary sample)
  19. Sorensen JT, Terkelsen CJ, Steengaard C, et al. Prehospital troponin T testing in the diagnosis and triage of patients with suspected acute myocardial infarction. Am J Cardiol. 2011;107(10):1436-1440. (Prospective; 4905 patients)
  20. Ezekowitz JA, Welsh RC, Weiss D, et al. Providing rapid out of hospital acute cardiovascular treatment 4 (PROACT-4). J Am Heart Assoc. 2015;4(12):e002859. (Randomized controlled trial; 601 patients)
  21. Layfield C, Rose J, Alford A, et al. Effectiveness of practices for improving the diagnostic accuracy of non ST elevation myocardial infarction in the emergency department: a laboratory medicine best practices (TM) systematic review. Clin Biochem. 2015;48(4-5):204-212. (Systematic review; 58 studies)
  22. * Fanaroff AC, Rymer JA, Goldstein SA, et al. Does this patient with chest pain have acute coronary syndrome? The Rational Clinical Examination systematic review. JAMA. 2015;314(18):1955-1965. (Systematic review)
  23. Swap C, Nagurney J. Value and limitations of chest pain history in the evaluation of patients with suspected acute coronary syndromes. JAMA. 2005;294(20):2623-2629. (Review)
  24. Milner KA, Vaccarino V, Arnold AL, et al. Gender and age differences in chief complaints of acute myocardial infarction (Worcester Heart Attack Study). Am J Cardiol. 2004;93(5):606-608. (Retrospective; 2073 patients)
  25. Culic V, Eterovic D, Miric D, et al. Symptom presentation of acute myocardial infarction: influence of sex, age, and risk factors. Am Heart J. 2002;144(6):1012-1017. (Prospective observational; 1996 patients)
  26. Diamond GA, Forrester JS. Analysis of probability as an aid in the clinical diagnosis of coronary-artery disease. N Engl J Med. 1979;300(24):1350-1358. (Review)
  27. Chaitman BR, Bourassa MG, Davis K, et al. Angiographic prevalence of high-risk coronary artery disease in patient subsets (CASS). Circulation. 1981;64(2):360-367. (Retrospective; 8157 patients)
  28. Pryor DB, Harrell FE, Lee KL, et al. Estimating the likelihood of significant coronary artery disease. Am J Med. 1983;75(5):771-780. (Retrospective; 5438 patients)
  29. Cheng VY, Berman DS, Rozanski A, et al. Performance of the traditional age, sex, and angina typicality-based approach for estimating pretest probability of angiographically significant coronary artery disease in patients undergoing coronary computed tomographic angiography: results from the multinational coronary CT angiography evaluation for clinical outcomes: an international multicenter registry (CONFIRM). Circulation. 2011;124(22):2423-2432. (Prospective; 14,048 patients)
  30. Jayes R, Beshansky J, Dagostino R, et al. Do patients’ coronary risk factor reports predict acute cardiac ischemia in the emergency department? A multicenter study. J Clin Epidemiol. 1992;45(6):621-626. (Retrospective; 1743 patients)
  31. Body R, McDowell G, Carley S, et al. Do risk factors for chronic coronary heart disease help diagnose acute myocardial infarction in the emergency department? Resuscitation. 2008;79(1):41-45. (Prospective cohort; 796 patients)
  32. Han JH, Lindsell CJ, Storrow AB, et al. The role of cardiac risk factor burden in diagnosing acute coronary syndromes in the emergency department setting. Ann Emerg Med. 2007;49(2):145-152.e1. (Post hoc analysis of prospective cohort; 10,806 patients)
  33. Courtney DM, Kline JA, Kabrhel C, et al. Clinical features from the history and physical examination that predict the presence or absence of pulmonary embolism in symptomatic emergency department patients: results of a prospective, multicenter study. Ann Emerg Med. 2010;55(4):307-315. (Prospective cohort; 7940 patients)
  34. von Kodolitsch Y, Schwartz A, Nienaber C. Clinical prediction of acute aortic dissection. Arch Intern Med. 2000;160(19):2977-2982. (Prospective cohort; 250 patients)
  35. Davis M, Lewell M, McLeod S, et al. A prospective evaluation of the utility of the prehospital 12-lead electrocardiogram to change patient management in the emergency department. Prehosp Emerg Care. 2014;18(1):9-14. (Prospective; 281 patients)
  36. Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics -- 2016 update: a report from the American Heart Association. Circulation. 2016;133(4):e38-e360. (Consensus report)
  37. Nikus K, Pahlm O, Wagner G, et al. Electrocardiographic classification of acute coronary syndromes: a review by a committee of the International Society for Holter and Non-Invasive Electrocardiology. J Electrocardiol. 2010;43(2):91-103. (Review)
  38. Patel JH, Gupta R, Roe MT, et al. Influence of presenting electrocardiographic findings on the treatment and outcomes of patients with non-ST-segment elevation myocardial infarction. Am J Cardiol. 2014;113(2):256-261. (Retrospective; 175,556 patients)
  39. Knowlman T, Greenslade JH, Parsonage W, et al. The association of electrocardiographic abnormalities and acute coronary syndrome in emergency patients with chest pain. Acad Emerg Med. 2017;24(3):344-352. (Retrospective; 2353 patients)
  40. * Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Neth Heart J. 2008;16(6):191-196. (Prospective; 120 patients)
  41. Welch R, Zalenski R, Frederick P, et al. Prognostic value of a normal or nonspecific initial electrocardiogram in acute myocardial infarction. JAMA. 2001;286(16):1977-1984. (Retrospective; 1,310,030 patients)
  42. Lee KK, Shah ASV, Mills NL. Diagnosis of myocardial infarction: cardiac troponin I or troponin T? Clin Biochem. 2014;47(6):319-320. (Editorial)
  43. Keller T, Zeller T, Peetz D, et al. Sensitive troponin I assay in early diagnosis of acute myocardial infarction. N Engl J Med. 2009;361(9):868-877. (Prospective; 1818 patients)
  44. Reichlin T, Hochholzer W, Bassetti S, et al. Early diagnosis of myocardial infarction with sensitive cardiac troponin assays. N Engl J Med. 2009;361(9):858-867. (Prospective; 718 patients)
  45. Alcalai R, Planer D, Culhaoglu A, et al. Acute coronary syndrome vs nonspecific troponin elevation: clinical predictors and survival analysis. Arch Intern Med. 2007;167(3):276-281. (Retrospective; 615 patients)
  46. Newby LK, Jesse RL, Babb JD, et al. ACCF 2012 expert consensus document on practical clinical considerations in the interpretation of troponin elevations: a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol. 2012;60(23):2427-2463. (Consensus guideline)
  47. Wu AHB, Jaffe AS, Apple FS, et al. National Academy of Clinical Biochemistry Laboratory Medicine practice guidelines: use of cardiac troponin and B-type natriuretic peptide or N-terminal proB-type natriuretic peptide for etiologies other than acute coronary syndromes and heart failure. Clin Chem. 2007;53(12):2086-2096. (Practice guidelines)
  48. Cullen L, Than M, Brown AFT, et al. Comprehensive standardized data definitions for acute coronary syndrome research in emergency departments in Australasia. Emerg Med Australas. 2010;22(1):35-55. (Consensus statement)
  49. Antman EM, Cohen M, Bernink PJ, et al. The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making. JAMA. 2000;284(7):835-842. (Randomized controlled; 1957 patients)
  50. Hess EP, Agarwal D, Chandra S, et al. Diagnostic accuracy of the TIMI risk score in patients with chest pain in the emergency department: a meta-analysis. Can Med Assoc J. 2010;182(10):1039-1044. (Meta-analysis; 17,265 patients)
  51. Than M, Cullen L, Reid CM, et al. A 2-h diagnostic protocol to assess patients with chest pain symptoms in the Asia-Pacific region (ASPECT): a prospective observational validation study. Lancet. 2011;377(9771):1077-1084. (Prospective observational; 3582 patients)
  52. Than M, Cullen L, Aldous S, et al. 2-hour accelerated diagnostic protocol to assess patients with chest pain symptoms using contemporary troponins as the only biomarker: the ADAPT trial. J Am Coll Cardiol. 2012;59(23):2091-2098. (Prospective observational; 1975 patients)
  53. Backus BE, Six AJ, Kelder JC, et al. Chest pain in the emergency room: a multicenter validation of the HEART Score. Crit Pathw Cardiol. 2010;9(3):164-169. (Retrospective; 880 patients)
  54. Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013;168(3):2153-2158. (Prospective; 880 patients)
  55. Six AJ, Cullen L, Backus BE, et al. The HEART score for the assessment of patients with chest pain in the emergency department: a multinational validation study. Crit Pathw Cardiol. 2013;12(3):121-126. (Retrospective; 2906 patients)
  56. Mahler SA, Hiestand BC, Goff DC Jr, et al. Can the HEART score safely reduce stress testing and cardiac imaging in patients at low risk for major adverse cardiac events? Crit Pathw Cardiol. 2011;10(3):128-133. (Retrospective; 1070 patients)
  57. Christenson J, Innes G, McKnight D, et al. A clinical prediction rule for early discharge of patients with chest pain. Ann Emerg Med. 2006;47(1):1-10. (Prospective cohort; 769 patients)
  58. Jalili M, Hejripour Z, Honarmand AR, et al. Validation of the Vancouver Chest Pain Rule: a prospective cohort study. Acad Emerg Med. 2012;19(7):837-842. (Prospective cohort; 593 patients)
  59. Cullen L, Greenslade JH, Than M, et al. The new Vancouver Chest Pain Rule using troponin as the only biomarker: an external validation study. Am J Emerg Med. 2014;32(2):129-134. (Retrospective analysis of a prospective observational study; 1635 patients)
  60. Greenslade JH, Cullen L, Than M, et al. Validation of the Vancouver Chest Pain Rule using troponin as the only biomarker: a prospective cohort study. Am J Emerg Med. 2013;31(7):1103-1107. (Prospective cohort; 1635 patients)
  61. Hess EP, Brison RJ, Perry JJ, et al. Development of a clinical prediction rule for 30-day cardiac events in emergency department patients with chest pain and possible acute coronary syndrome. Ann Emerg Med. 2012;59(2):115-125. (Prospective observational cohort; 2718 patients)
  62. Mahler SA, Miller CD, Hollander JE, et al. Identifying patients for early discharge: performance of decision rules among patients with acute chest pain. Int J Cardiol. 2013;168(2):795-802. (Retrospective review of a prospective cohort study; 988 patients)
  63. Goldman L, Weinberg M, Weisberg M, et al. A computer-derived protocol to aid in the diagnosis of emergency room patients with acute chest pain. N Engl J Med. 1982;307(10):588-596. (Prospective observational; 482 patients in derivation, 468 patients in validation)
  64. Selker HP, Griffith JL, D’Agostino RB. A tool for judging coronary care unit admission appropriateness, valid for both real-time and retrospective use: a time-insensitive predictive instrument (TIPI) for acute cardiac ischemia. A multicenter study. Med Care. 1991;29(7):610-627. (Prospective observational; 5773 patients)
  65. Chase M, Robey JL, Zogby KE, et al. Prospective validation of the thrombolysis in myocardial infarction risk score in the emergency department chest pain population. Ann Emerg Med. 2006;48(3):252-259. (Prospective observational cohort study; 1458 patients)
  66. Pollack CV, Sites FD, Shofer FS, et al. Application of the TIMI risk score for unstable angina and non-ST elevation acute coronary syndrome to an unselected emergency department chest pain population. Acad Emerg Med. 2006;13(1):13-18. (Analysis of prospective observational cohort study; 3929 patients)
  67. Boersma E, Pieper KS, Steyerberg EW, et al. Predictors of outcome in patients with acute coronary syndromes without persistent ST-segment elevation: results from an international trial of 9461 patients. Circulation. 2000;101(22):2557-2567. (Secondary analysis of randomized controlled trial; 9461 patients)
  68. Granger CB, Goldberg RJ, Dabbous O, et al. Predictors of hospital mortality in the Global Registry of Acute Coronary Events. Arch Intern Med. 2003;163(19):2345-2353. (Retrospective; 11,389 patients)
  69. Acute Coronary Syndrome Guidelines Working Group. Guidelines for the management of acute coronary syndromes 2006. Med J Aust. 2006;184(8 Suppl):S1-S30. (Consensus guideline)
  70. Kelly A. How useful are the Heart Foundation risk criteria for assessment of emergency department patients with chest pain? Emerg Med Australas. 2012;24(3):260-265. (Prospective observational; 768 patients)
  71. Macdonald SPJ, Nagree Y, Fatovich DM, et al. Comparison of two clinical scoring systems for emergency department risk stratification of suspected acute coronary syndrome. Emerg Med Australas. 2011;23(6):717-725. (Prospective observational; 223 patients)
  72. Cullen L, Greenslade J, Hammett CJ, et al. Comparison of three risk stratification rules for predicting patients with acute coronary syndrome presenting to an Australian emergency department. Heart Lung Circ. 2013;22(10):844-851. (Secondary analysis of a prospective observational study; 948 patients)
  73. Scheuermeyer FX, Wong H, Yu E, et al. Development and validation of a prediction rule for early discharge of low-risk emergency department patients with potential ischemic chest pain. CJEM. 2014;16(2):106-119. (Prospective cohort; 1669 patients)
  74. Than M, Flaws D, Sanders S, et al. Development and validation of the emergency department assessment of chest pain score and 2-h accelerated diagnostic protocol. Emerg Med Australas. 2014;26(1):34-44. (Retrospective derivation and prospective validation; 1974 and 608 patients)
  75. Hess EP, Thiruganasambandamoorthy V, Wells GA, et al. Diagnostic accuracy of clinical prediction rules to exclude acute coronary syndrome in the emergency department setting: a systematic review. Can J Emerg Med. 2008;10(4):373-382. (Systematic review; 8 studies, 7937 patients)
  76. Steurer J, Held U, Schmid D, et al. Clinical value of diagnostic instruments for ruling out acute coronary syndrome in patients with chest pain: a systematic review. Emerg Med J. 2010;27(12):896-902. (Systematic review; 20 derivation studies)
  77. * Than MP, Flaws DF, Cullen L, et al. Cardiac risk stratification scoring systems for suspected acute coronary syndromes in the emergency department. Curr Emerg Hosp Med Rep. 2013;1(1):53-63. (Review)
  78. Hess EP, Perry JJ, Ladouceur P, et al. Derivation of a clinical decision rule for chest radiography in emergency department patients with chest pain and possible acute coronary syndrome. CJEM. 2010;12(2):128-134. (Prospective cohort; 529 patients)
  79. Poku JK, Bellamkonda-Athmaram VR, Fernanda Bellolio M, et al. Failure of prospective validation and derivation of a refined clinical decision rule for chest radiography in emergency department patients with chest pain and possible acute coronary syndrome. Acad Emerg Med. 2012;19(9):e1004-e1010. (Prospective observational; 1159 patients)
  80. * Miller TD, Askew JW, Anavekar NS. Noninvasive stress testing for coronary artery disease. Cardiol Clin. 2014;32(3):387-404. (Review)
  81. Fihn SD, Gardin JM, Abrams J, et al. 2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS guideline for the diagnosis and management of patients with stable ischemic heart disease. J Am Coll Cardiol. 2012;60(24):e44-e164. (Consensus guideline)
  82. Stratmann H, Williams G, Wittry M, et al. Exercise tc-99m sestamibi tomography for cardiac risk stratification of patients with stable chest pain. Circulation. 1994;89(2):615-622. (Prospective; 521 patients)
  83. Amsterdam E, Kirk J, Diercks D, et al. Immediate exercise testing to evaluate low-risk patients presenting to the emergency department with chest pain. J Am Coll Cardiol. 2002;40(2):251-256. (Prospective observational; 1000 patients)
  84. Hulten EA, Carbonaro S, Petrillo SP, et al. Prognostic value of cardiac computed tomography angiography: a systematic review and meta-analysis. J Am Coll Cardiol. 2011;57(10):1237-1247. (Systematic review and meta-analysis)
  85. Arbab-Zadeh A. Stress testing and non-invasive coronary angiography in patients with suspected coronary artery disease: time for a new paradigm. Heart Int. 2012;7(1):4-13. (Review)
  86. Hermann LK, Newman DH, Pleasant WA, et al. Yield of routine provocative cardiac testing among patients in an emergency department-based chest pain unit. JAMA Intern Med. 2013;173(12):1128-1133. (Prospective observational; 4181 patients)
  87. Nabi F, Chang SM, Xu J, et al. Assessing risk in acute chest pain: the value of stress myocardial perfusion imaging in patients admitted through the emergency department. J Nucl Cardiol. 2012;19(2):233-243. (Prospective observational; 1576 patients)
  88. Greenslade JH, Parsonage W, Ho A, et al. Utility of routine exercise stress testing among intermediate risk chest pain patients attending an emergency department. Heart Lung Circ. 2015;24(9):879-884. (Prospective observational; 1205 patients)
  89. Winchester DE, Brandt J, Schmidt C, et al. Diagnostic yield of routine noninvasive cardiovascular testing in low-risk acute chest pain patients. Am J Cardiol. 2015;116(2):204-207. (Prospective cohort; 213 patients)
  90. Cremer PC, Khalaf S, Agarwal S, et al. Myocardial perfusion imaging in emergency department patients with negative cardiac biomarkers yield for detecting ischemia, short-term events, and impact of downstream revascularization on mortality. Circ Cardiovasc Imaging. 2014;7(6):912-919. (Retrospective; 5354 patients)
  91. Safavi KC, Li S, Dharmarajan K,et al. Hospital variation in the use of noninvasive cardiac imaging and its association with downstream testing, interventions, and outcomes. JAMA Intern Med. 2014;174(4):546-553. (Retrospective; 549,078 patients)
  92. Rahman F, Mitra B, Cameron PA, et al. Stress testing before discharge is not required for patients with low and intermediate risk of acute coronary syndrome after emergency department short stay assessment. Emerg Med Australas. 2010;22(5):449-456. (Prospective observational; 300 patients)
  93. Scott AC, Bilesky J, Lamanna A, et al. Limited utility of exercise stress testing in the evaluation of suspected acute coronary syndrome in patients aged less than 40 years with intermediate risk features. Emerg Med Australas. 2014;26(2):170-176. (Retrospective observational; 1027 patients)
  94. Foy AJ, Liu G, Davidson WR Jr, et al. Comparative effectiveness of diagnostic testing strategies in emergency department patients with chest pain an analysis of downstream testing, interventions, and outcomes. JAMA Intern Med. 2015;175(3):428-436. (Retrospective; 421,774 patients)
  95. Morris JR, Bellolio MF, Sangaralingham LR, et al. Comparative trends and downstream outcomes of coronary CT angiography and cardiac stress testing in emergency department patients with chest pain: an administrative claims analysis. Acad Emerg Med. 2016;23(9):1022-1030. (Retrospective; 2,047,799 patient visits)
  96. Hulten E, Pickett C, Bittencourt MS, et al. Outcomes after coronary computed tomography angiography in the emergency department: a systematic review and meta-analysis of randomized, controlled trials. J Am Coll Cardiol. 2013;61(8):880-892. (Meta-analysis; 1869 patients)
  97. Collins R, Peto R, Hennekens C, et al. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009;373(9678):1849-1860. (Meta-analysis)
  98. U.S. Preventive Services Task Force. Final update summary: aspirin use to prevent cardiovascular disease and colorectal cancer: preventive medication. Published April 2016.Available at: http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/aspirin-to-prevent-cardiovascular-disease-and-cancer?ds=1&s=aspirin. Accessed May 26, 2017. (Consensus guideline)
  99. Brody A, Rahman T, Reed B, et al. Safety and efficacy of antihypertensive prescription at emergency department discharge. Acad Emerg Med. 2015;22(5):632-635. (Retrospective; 217 patients)
  100. Wolf SJ, Lo B, Shih RD, et al. Clinical policy: critical issues in the evaluation and management of adult patients in the emergency department with asymptomatic elevated blood pressure. Ann Emerg Med. 2013;62(1):59-68. (Clinical policy)
  101. Douglas PS, Ginsburg GS. The evaluation of chest pain in women. N Engl J Med. 1996;334(20):1311-1315. (Review)
  102. Macfarlane PW. Age, sex, and the ST amplitude in health and disease. J Electrocardiol. 2001;34(4, Part B):235-241. (Prospective; 1338 patients)
  103. Kwok Y, Kim C, Grady D, et al. Meta-analysis of exercise testing to detect coronary artery disease in women. Am J Cardiol. 1999;83(5):660-666. (Meta-analysis; 3721 patients)
  104. Walker NJ, Sites FD, Shofer FS, et al. Characteristics and outcomes of young adults who present to the emergency department with chest pain. Acad Emerg Med. 2001;8(7):703-708. (Prospective cohort; 527 patient visits)
  105. Collin MJ, Weisenthal B, Walsh KM, et al. Young patients with chest pain: 1-year outcomes. Am J Emerg Med. 2011;29(3):265-270. (Prospective cohort; 609 patients)
  106. Marsan R, Shaver K, Sease K, et al. Evaluation of a clinical decision rule for young adult patients with chest pain. Acad Emerg Med. 2005;12(1):26-31. (Prospective cohort; 1023 patients)
  107. Hermann LK, Weingart SD, Duvall WL, et al. The limited utility of routine cardiac stress testing in emergency department chest pain patients younger than 40 years. Ann Emerg Med. 2009;54(1):12-16. (Retrospective observational; 220 patients)
  108. Ely S, Chandra A, Mani G, et al. Utility of observation units for young emergency department chest pain patients. J Emerg Med. 2013;44(2):306-312. (Retrospective observational; 362 patients)
  109. Napoli AM, Tran S, Wang J. Low-risk chest pain patients younger than 40 years do not benefit from admission and stress testing. Crit Pathw Cardiol. 2013;12(4):201-203. (Retrospective observational; 384 patients)
  110. Kelly BS. Evaluation of the elderly patient with acute chest pain. Clin Geriatr Med. 2007;23(2):327-349. (Review)
  111. Webb IG, Yam ST, Cooke R, et al. Elevated baseline cardiac troponin levels in the elderly -- another variable to consider? Heart Lung Circ. 2015;24(2):142-148. (Retrospective; 3219 patients)
  112. Han JH, Lindsell CJ, Hornung RW, et al. The elder patient with suspected acute coronary syndromes in the emergency department. Acad Emerg Med. 2007;14(8):732-739. (Post hoc analysis; 10,126 patients)
  113. Michael MA, El Masry H, Khan BR, et al. Electrocardiographic signs of remote myocardial infarction. Prog Cardiovasc Dis. 2007;50(3):198-208. (Review)
  114. Papanicolaou MN, Califf RM, Hlatky MA, et al. Prognostic implications of angiographically normal and insignificantly narrowed coronary arteries. Am J Cardiol. 1986;58(13):1181-1187. (Retrospective; 1977 patients)
  115. Pitts WR, Lange RA, Cigarroa JE, et al. Repeat coronary angiography in patients with chest pain and previously normal coronary angiogram. Am J Cardiol. 1997;80(8):1086-1087. (Retrospective; 17 patients)
  116. Vysma C. Breakthrough development for Americans with suspected heart attack – next generation Troponin T test from Roche cleared by FDA. https://usdiagnostics.roche.com/en/document/Gen-5-Troponin-Press-Release-PP-US-09823.pdf. Published January 19, 2017. Accessed April 30, 2017. (Press release)
  117. Reiter M, Twerenbold R, Reichlin T, et al. Early diagnosis of acute myocardial infarction in patients with pre-existing coronary artery disease using more sensitive cardiac troponin assays. Eur Heart J. 2012;33(8):988-997. (Prospective observational; 1098 patients)
  118. Body R, Carley S, McDowell G, et al. Rapid exclusion of acute myocardial infarction in patients with undetectable troponin using a high-sensitivity assay. J Am Coll Cardiol. 2011;58(13):1332-1339. (Prospective cohort and prospective validation; 703 and 915 patients, respectively)
  119. Rubini Giménez M, Hoeller R, Reichlin T, et al. Rapid rule out of acute myocardial infarction using undetectable levels of high-sensitivity cardiac troponin. Int J Cardiol. 2013;168(4):3896-3901. (Prospective observational; 2072 patients)
  120. Bandstein N, Ljung R, Johansson M, et al. Undetectable high-sensitivity cardiac troponin T level in the emergency department and risk of myocardial infarction. J Am Coll Cardiol. 2014;63(23):2569-2578. (Retrospective; 14,636 patients)
  121. * Korley FK, Jaffe AS. Preparing the United States for high-sensitivity cardiac troponin assays. J Am Coll Cardiol. 2013;61(17):1753-1758. (Review)
  122. Braunwald E, Morrow DA. Unstable angina - is it time for a requiem? Circulation. 2013;127(24):2452-2457. (Review)
  123. Reichlin T, Twerenbold R, Reiter M, et al. Introduction of high-sensitivity troponin assays: impact on myocardial infarction incidence and prognosis. Am J Med. 2012;125(12):1205-1213.e1. (Prospective observational; 1124 patients)
  124. Yoon YE, Wann S. Evaluation of acute chest pain in the emergency department: “triple rule-out” computed tomography angiography. Cardiol Rev. 2011;19(3):115-121. (Review)
  125. Ayaram D, Bellolio MF, Murad MH, et al. Triple rule-out computed tomographic angiography for chest pain: a diagnostic systematic review and meta-analysis. Acad Emerg Med. 2013;20(9):861-871. (Meta-analysis; 3539 patients)
  126. Burris II AC, Boura JA, Raff GL, et al. Triple rule out versus coronary CT angiography in patients with acute chest pain: results from the ACIC Consortium. JACC Cardiovasc Imaging. 2015;8(7):817-825. (Retrospective; 12,834 patients)
  127. Vibhakar N, Mattu A. Beyond HEART: building a better chest pain protocol. Available at: http://epmonthly.com/article/beyond-heart-building-a-better-chest-pain-protocol/. Published October 1, 2015. Accessed May 2, 2017. (Clinical research report)

 

Publication Information
Authors

David Markel, MD

Publication Date

July 1, 2017

CME Expiration Date

July 31, 2020

Get Permission

CME Information

Related Articles

Evaluation And Management Of Non-ST-Segment Elevation Acute Coronary Syndromes In The Emergency Department - (FREE) - Emergency Medicine Practice - January 2010

The Diagnosis And Treatment Of STEMI In The Emergency Department - (FREE) - Emergency Medicine Practice - June

Get Quick-Read Evidence-Based Updates
Enter your email to get free evidence-based content delivered to your inbox once per month.
Please provide a valid email address.