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Feasibility and Safety of Evaluating Patients with Prior Coronary Artery Disease Using an Accelerated Diagnostic

Roy Beigel1, Alexander Fardman1, Ronen Goldkorn1

  • 1The Leviev Heart Center, Sheba Medical Center, Tel-Hashomer, affiliated to The Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel.

Plos One
|September 27, 2016
PubMed

Insights

Patients with prior coronary artery disease (CAD) can safely use accelerated diagnostic protocols in a chest pain unit (CPU). This approach yields similar outcomes to those without a history of CAD, ensuring efficient evaluation.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Diagnostic Protocols

Background:

  • Accelerated diagnostic protocols are standard for low-risk acute chest pain.
  • Limited data exist on their use in patients with prior coronary artery disease (CAD).

Purpose of the Study:

  • To assess the feasibility and safety of accelerated diagnostic protocols for patients with a history of prior CAD.
  • To compare outcomes in patients with and without prior CAD using these protocols.

Main Methods:

  • Evaluated 1,220 consecutive acute chest pain patients in a chest pain unit (CPU).
  • Stratified patients based on history of prior CAD.
  • Assessed a composite primary outcome of readmission, acute coronary syndrome, revascularization, or death at 60 days.

Main Results:

  • 268 patients (22%) had a history of prior CAD.
  • Hospitalization rates, coronary angiography, and revascularization rates were similar between groups.
  • The 60-day primary endpoint occurred in 1.6% of patients without prior CAD and 3.2% of patients with prior CAD (p=0.836).

Conclusions:

  • Accelerated diagnostic protocols are feasible and safe for evaluating patients with prior CAD in a CPU.
  • Outcomes for patients with prior CAD using these protocols do not differ significantly from those without prior CAD.

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