Predictores de síndrome coronario agudo sin supradesnivel del ST y estratificación de riesgo en la unidad de dolor torácico. Experiencia en 1.168 pacientes

Background: Nearly 10% 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 and methods: Prospective evaluation of pat...

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Autores principales:	Gabrielli,Luigi A, Castro,Pablo F, Verdejo,Hugo E, McNab,Paul A, Llevaneras,Silvana A, Mardonez,José M, Corbalán,Ramón L
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2008
Materias:	Acute coronary syndrome Risk factors Troponin T-1
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000400004
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spelling	oai:scielo:S0034-988720080004000042008-06-16Predictores de síndrome coronario agudo sin supradesnivel del ST y estratificación de riesgo en la unidad de dolor torácico. Experiencia en 1.168 pacientesGabrielli,Luigi ACastro,Pablo FVerdejo,Hugo EMcNab,Paul ALlevaneras,Silvana AMardonez,José MCorbalán,Ramón L Acute coronary syndrome Risk factors Troponin T-1 Background: Nearly 10% 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 and methods: 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% males), were studied. After initial evaluation, 62% of the patients were admitted to the hospital for further testing and in 71% 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% confidence intervals (CI) 3.61-7.99), two or more cardiovascular risk factors (OR 2.16, 95% CI 1.21-2.84), cervical irradiation of the pain (OR 1.84, 95% CI 1.25-2.69), age over 65years (OR 1.73, 95% CI (1.32-2.27) and a Troponin I above the upper normal limit (OR: 5.68, 95% 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 detectioninfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.136 n.4 20082008-04-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000400004es10.4067/S0034-98872008000400004
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Acute coronary syndrome Risk factors Troponin T-1
spellingShingle	Acute coronary syndrome Risk factors Troponin T-1 Gabrielli,Luigi A Castro,Pablo F Verdejo,Hugo E McNab,Paul A Llevaneras,Silvana A Mardonez,José M Corbalán,Ramón L Predictores de síndrome coronario agudo sin supradesnivel del ST y estratificación de riesgo en la unidad de dolor torácico. Experiencia en 1.168 pacientes
description	Background: Nearly 10% 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 and methods: 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% males), were studied. After initial evaluation, 62% of the patients were admitted to the hospital for further testing and in 71% 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% confidence intervals (CI) 3.61-7.99), two or more cardiovascular risk factors (OR 2.16, 95% CI 1.21-2.84), cervical irradiation of the pain (OR 1.84, 95% CI 1.25-2.69), age over 65years (OR 1.73, 95% CI (1.32-2.27) and a Troponin I above the upper normal limit (OR: 5.68, 95% 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
author	Gabrielli,Luigi A Castro,Pablo F Verdejo,Hugo E McNab,Paul A Llevaneras,Silvana A Mardonez,José M Corbalán,Ramón L
author_facet	Gabrielli,Luigi A Castro,Pablo F Verdejo,Hugo E McNab,Paul A Llevaneras,Silvana A Mardonez,José M Corbalán,Ramón L
author_sort	Gabrielli,Luigi A
title	Predictores de síndrome coronario agudo sin supradesnivel del ST y estratificación de riesgo en la unidad de dolor torácico. Experiencia en 1.168 pacientes
title_short	Predictores de síndrome coronario agudo sin supradesnivel del ST y estratificación de riesgo en la unidad de dolor torácico. Experiencia en 1.168 pacientes
title_full	Predictores de síndrome coronario agudo sin supradesnivel del ST y estratificación de riesgo en la unidad de dolor torácico. Experiencia en 1.168 pacientes
title_fullStr	Predictores de síndrome coronario agudo sin supradesnivel del ST y estratificación de riesgo en la unidad de dolor torácico. Experiencia en 1.168 pacientes
title_full_unstemmed	Predictores de síndrome coronario agudo sin supradesnivel del ST y estratificación de riesgo en la unidad de dolor torácico. Experiencia en 1.168 pacientes
title_sort	predictores de síndrome coronario agudo sin supradesnivel del st y estratificación de riesgo en la unidad de dolor torácico. experiencia en 1.168 pacientes
publisher	Sociedad Médica de Santiago
publishDate	2008
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872008000400004
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Predictores de síndrome coronario agudo sin supradesnivel del ST y estratificación de riesgo en la unidad de dolor torácico. Experiencia en 1.168 pacientes

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