Related Experiment Video
Updated: Jun 16, 2025
14:27
Identification of Disease-related Spatial Covariance Patterns using Neuroimaging Data
Published on: June 26, 2013
15.6K
NICE guidelines in the Sunderland RACPC cohort study: one size does not fit all.
Kerrick Hesse1, Zaw Htet2, Mickey Jachuck3
1Cardiology Registrar (ST6).
The British Journal of Cardiology
|August 15, 2024
Summary
Patients with typical angina in rapid access chest pain clinics (RACPC) face higher risks of obstructive coronary artery disease (CAD) and major adverse cardiovascular events (MACE). Invasive coronary angiography (ICA) remains effective for diagnosis and treatment when CTCA capacity is limited.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Public Health
Background:
- Undifferentiated chest pain accounts for significant general practitioner (GP) and accident and emergency (A&E) attendances.
- Rapid access chest pain clinics (RACPC) manage suspected cardiac chest pain, with NICE guidelines recommending computed tomography coronary angiography (CTCA) as a primary investigation.
- Evaluating the effectiveness and efficiency of local RACPC services is crucial for optimizing patient care.
Purpose of the Study:
- To assess the effectiveness and efficiency of a local RACPC in the Northeast of England.
- To compare demographics and major adverse cardiovascular events (MACE) among patients with typical, atypical, and non-angina chest pain.
- To analyze the outcomes of anatomical and functional imaging, including CTCA and invasive coronary angiography (ICA).
Main Methods:
- Retrospective analysis of 401 unselected referrals to a RACPC in 2021.
- Comparison of baseline demographics and MACE based on chest pain classification (typical, atypical, non-angina).
- Modeling of obstructive coronary artery disease (CAD) incidence using backward stepwise binary logistic regression.
Main Results:
- Of 373 patients with chest pain, 37.3% had typical angina, 32.8% atypical, and 30.0% non-angina.
- Typical angina patients were older, had more cardiovascular risk factors, and a significantly higher risk of obstructive CAD (OR 6.27) and MACE (9.4%).
- 164 patients underwent ICA, revealing obstructive CAD in 26.2%, while 39 patients had CTCA, with 25.6% requiring subsequent ICA.
Conclusions:
- Patients presenting with typical angina exhibit a heightened risk of cardiovascular events.
- In settings with limited CTCA capacity, invasive coronary angiography (ICA) effectively diagnoses CAD and enables timely revascularization.
- Enhanced risk stratification and expanded non-invasive imaging are recommended to improve RACPC service delivery within cardiology networks.
Keywords:
anginacomputed tomography coronary angiographycoronary artery diseaseinvasive coronary angiographyrapid access chest pain clinicMore Related Videos
07:31Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
Published on: May 15, 2020
7.0K
14:43A Novel Method for Involving Women of Color at High Risk for Preterm Birth in Research Priority Setting
Published on: January 12, 2018
11.8K
Related Concept Videos
01:29Nursing Interventions II: Selecting and Classifying the Nursing Interventions
2.1K
Creating and executing a nursing diagnosis helps nurses plan care and guide patient, family, and community interventions. They are developed based on a patient's physical evaluation and support measuring the outcomes. It is not recommended to select random interventions throughout the planning process. Instead, consider the following six essential factors when choosing interventions:
2.1K
01:23Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
124
Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast,...
124
01:19Standards of Care II
638
Nurses bear specific legal responsibilities under several federal statutes, including:
638
01:22Standards of Care I
670
Federal statutes profoundly impact nursing practice, providing critical guidelines to ensure patient care is equitable, accessible, and of the highest quality. The following laws address distinct aspects of healthcare provision and patient rights:
670
01:11Variability: Analysis
135
Measures of variability are statistical metrics that reveal the dispersion pattern within a dataset. They are pivotal in biostatistics, providing insights into the heterogeneity within health and biological data. Variability signifies the degree to which data points diverge from one another, helping researchers understand the potential range of values and associated uncertainty within the data.
The range is a simple measure of variability, indicating the difference between the highest and...
The range is a simple measure of variability, indicating the difference between the highest and...
135
01:11Clinical Trials: Overview
2.9K
Clinical development focuses on how the drug will interact with the human body and encompasses four key phases of clinical trials, each serving a specific purpose in assessing the safety and effectiveness of new drugs. These phases overlap and build upon one another. Phase I involves a small group of healthy volunteers (typically 20-80 individuals) or, in cases where significant toxicity is expected, patients with the targeted disease, such as cancer or AIDS. The volunteers are tested for...
2.9K