1.) Marsan et al. Evaluation of a Clinical Decision Rule for Young Adult Patients with Chest Pain. Acad Emerg Med. 2005; 12(1): 24-31 (n=593). 2.) Walker 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 (n=312). 3.) Lee TH et al. Long-term survival of emergency department patients with acute chest pain. Am J Cardiol. 1992; 69:145–51 (n=333).
1.) Hollander JE, et al. Coronary computed tomographic angiography for rapid discharge of low-risk patients with potential acute coronary syndromes. Ann Emerg Med. 2009; 53:295-304.(n=568). 2.) Goldstein JA, et al. A randomized controlled trial of multi-slice coronary computed tomography for evaluation of acute chest pain. J Am Coll Cardiol. 2007;49:863-871.
Moderate Risk: 1/125 death/MI
Avg age 50, avg 2 Framingham RF, all admitted for nuclear stress
1.) (Mahmarian et al.) = Nabi et al. Coronary Artery Calcium Scoring in the Emergency Department: Identifying Which Patients With Chest Pain Can Be Safely Discharged Home. Ann Emerg Med. 2010; 56(3): 220-9
10,689 pts, 894 (8%) MI using CKMB, 19 (2%) missed MI at 24-72 hrs (0.18% overall miss rate), no stat sig diff in outcome. This is the source that is constantly referenced.
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Kit Tainter
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Stress Test Under 40 - Ann EM 2009.pdf ViewDownload
