PT  - JOURNAL ARTICLE
AU  - G L Taylor
AU  - N F Murphy
AU  - C Berry
AU  - J Christie
AU  - A Finlayson
AU  - K MacIntyre
AU  - C Morrison
AU  - J McMurray
TI  - Long-term outcome of low-risk patients attending a rapid-assessment chest pain clinic
AID  - 10.1136/hrt.2007.125344
DP  - 2008 May 01
TA  - Heart
PG  - 628--632
VI  - 94
IP  - 5
4099  - http://heart.bmj.com/content/94/5/628.short
4100  - http://heart.bmj.com/content/94/5/628.full
SO  - Heart2008 May 01; 94
AB  - Objective: To examine the long-term outcome of patients evaluated in a rapid assessment chest pain clinic (RACPC): are “low-risk” patients safely reassured? Design: Retrospective cohort study. Setting: Staff grade-led RACPC in an urban teaching hospital. Participants: 3378 patients (51% male), attending the RACPC between April 1996 and February 2000. Main outcome measures: Death, coronary mortality, morbidity and revascularisation over a median follow-up of 6 years. Coronary standardised mortality ratio (SMR). Results: 2036 (60.3%) patients were categorised as “low risk”, 957 (28.3%) as having “stable coronary artery disease” and 214 (6.3%) as being an “acute coronary syndrome”. During the study, 3.6% of patients in the low risk category, 11.9% in the stable coronary artery disease category and 24.6% in the acute coronary syndrome category died from coronary artery disease or had a myocardial infarction. 5.5%, 18.2% and 18.4%, respectively, died from any cause. Compared to the local population (coronary SMR  = 100), our “low risk/non-coronary chest pain” cohort had a coronary SMR of 51 (95% CI 31 to 83), the “stable coronary artery disease” cohort 240 (187 to 308) and the “acute coronary syndrome” cohort 780 (509 to 1196). Conclusion: The RACPC was effective at triaging patients with chest pain. Patients identified as at “low risk” were unlikely to have an adverse coronary outcome and were appropriately reassured.