Applying the diamond criteria could improve utilization of stress echocardiography for patients who present to the emergency department with low-risk chest pain

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5 Citations (Scopus)

Abstract

We identified all patients with age 21 years and older, without a history of obstructive coronary artery disease, who presented to the emergency department with chest pain, and were admitted for cardiac observation followed by stress echocardiography during a 1-year period. The positive predictive value of stress echocardiography and cardiovascular outcomes were compared based on patients' Diamond chest pain classification. In patients with typical chest pain, who accounted for 8.7% (44/503) of the total cohort, the positive predictive value of stress echocardiography was 75% compared with 0% for all other subgroups (P = 0.007). Six patients (14%) with typical chest pain went on to have coronary revascularization compared with 0% for all other subgroups (P < 0.001). No patient in any subgroup died or was readmitted with a myocardial infarction in 30 days. Applying the Diamond criteria could improve utilization of stress echocardiography for patients with low-risk chest pain in the emergency department.

Original languageEnglish (US)
Pages (from-to)49-54
Number of pages6
JournalCritical Pathways in Cardiology
Volume13
Issue number2
DOIs
StatePublished - 2014

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Stress Echocardiography
Diamond
Chest Pain
Hospital Emergency Service
Coronary Artery Disease
Myocardial Infarction
Observation

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Medicine(all)

Cite this

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title = "Applying the diamond criteria could improve utilization of stress echocardiography for patients who present to the emergency department with low-risk chest pain",
abstract = "We identified all patients with age 21 years and older, without a history of obstructive coronary artery disease, who presented to the emergency department with chest pain, and were admitted for cardiac observation followed by stress echocardiography during a 1-year period. The positive predictive value of stress echocardiography and cardiovascular outcomes were compared based on patients' Diamond chest pain classification. In patients with typical chest pain, who accounted for 8.7{\%} (44/503) of the total cohort, the positive predictive value of stress echocardiography was 75{\%} compared with 0{\%} for all other subgroups (P = 0.007). Six patients (14{\%}) with typical chest pain went on to have coronary revascularization compared with 0{\%} for all other subgroups (P < 0.001). No patient in any subgroup died or was readmitted with a myocardial infarction in 30 days. Applying the Diamond criteria could improve utilization of stress echocardiography for patients with low-risk chest pain in the emergency department.",
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AU - Foy, Andrew

AU - Baquero, Giselle A.

AU - Naccarelli, Gerald

AU - Kozak, Mark

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