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Outcomes of patients with low risk cardiac chest pain underwent immediate exercise testing: two months fallow up

Author(s): Saeed Abbasi | Kambiz Masoumi | Mohsen Ebrahimi | Mohammad Amin Zare | Mohammad Javad Alemzadeh Ansari

Journal: International Journal of Collaborative Research on Internal Medicine & Public Health
ISSN 1840-4529

Volume: 3;
Issue: 3;
Start page: 282;
Date: 2011;
Original page

Keywords: Chest pain | exercise testing | emergency department

Aims and Objective: The objective of our study was to evaluate the outcomes of patients with lowcardiac risk presenting to the emergency department (ED) with chest pain suggestive of a cardiac etiologyand underwent immediate exercise testing during two months follow up.Methods: From September 2007 to September 2008, all patients presenting to the ED of Rasool-e-AkramHospital in Tehran with chest pain compatible with a cardiac origin and clinical evidence of low risk oninitial assessment underwent immediate exercise treadmill testing according to the Bruce protocol.Method of sampling was non-probability and consecutive. Sixty days fallow up after exercise testing wasdone for determination of subsequent clinical status included myocardial infarction (MI), unstable anginapectoris (UAP), coronary artery disease (CAD) demonstrated by thallium scan scintigraphy or thecoronary angiography, undergoing a revascularization procedure, and death.Results: Exercise testing was performed to in 184 patients (116 men, 68 women; mean age 46.9±10.3years). Exercise testing was positive in 53 (28.8%), negative in 119 (64.7%), and nondiagnostic in 12patients (6.5%). Cardiac event in positive exercise testing group was occurred in 25 patients (45%), and innegative testing group was in 4 (3%). Cardiac event was occurred in no patients with nondiagnosticexercise testing. The negative predictive value (NPV) of the exercise test for non-traumatic low riskcardiac chest pain was 96.6% and positive predictive value (PPV) was 47.2%.Discussion: Our results emphasizes that the immediate exercise testing in the studied group of thepatients is a safe, non-invasive and useful test with a high NPV and moderate PPV that could help us inprognostic risk stratification of this group of patients.
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