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Risk stratification in chest pain patients undergoing nuclear stress testing: the Erlanger Stress Score.

Publication ,  Journal Article
Fesmire, FM; Buchheit, RC; Cao, Y; Severance, HW; Jang, Y; Heath, GW
Published in: Crit Pathw Cardiol
December 2012

BACKGROUND: Studies have individually reported the relationship of age, cardiac risk factors, and history of preexisting coronary artery disease (CAD) for predicting acute coronary syndromes in chest pain patients undergoing cardiac stress testing. In this study, we investigate the interplay of all these factors on the incidence of acute coronary syndromes to develop a tool that may assist physicians in the selection of appropriate chest pain patients for stress testing. METHODS: Retrospective analysis of a prospectively acquired database of consecutive chest pain patients undergoing nuclear stress testing. Backward stepwise logistic regression was used to develop a model for predicting risk of 30-day acute coronary events (ACE) using information obtained from age, sex, cardiac risk factors, and history of preexisting CAD. RESULTS: A total of 800 chest pain patients underwent nuclear stress testing. ACE occurred in 74 patients (9.3%). Logistic regression analysis found only 6 factors predictive of ACE: age, male sex, preexisting CAD, diabetes, and hyperlipidemia. Area under the receiver operator characteristic curve of this model for predicting ACE was 0.767 (95% confidence interval, 0.719-0.815). There were no cases of ACE in the 173 patients with predicted probability estimates ≤2.5% (95% confidence interval, 0%-2.1%). CONCLUSIONS: A regression model using age, sex, preexisting CAD, diabetes, and hyperlipidemia is predictive of 30-day ACE in chest pain patients undergoing nuclear stress testing. Prospective studies need to be performed to determine whether this model can assist physicians in the selection of appropriate low-to-intermediate risk chest pain patients for nuclear stress testing.

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Published In

Crit Pathw Cardiol

DOI

EISSN

1535-2811

Publication Date

December 2012

Volume

11

Issue

4

Start / End Page

171 / 176

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Predictive Value of Tests
  • Myocardial Perfusion Imaging
  • Middle Aged
  • Male
  • Logistic Models
  • Humans
 

Citation

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Fesmire, F. M., Buchheit, R. C., Cao, Y., Severance, H. W., Jang, Y., & Heath, G. W. (2012). Risk stratification in chest pain patients undergoing nuclear stress testing: the Erlanger Stress Score. Crit Pathw Cardiol, 11(4), 171–176. https://doi.org/10.1097/HPC.0b013e31826f367f
Fesmire, Francis M., Ron C. Buchheit, Yu Cao, Harry W. Severance, Yi Jang, and Gregory W. Heath. “Risk stratification in chest pain patients undergoing nuclear stress testing: the Erlanger Stress Score.Crit Pathw Cardiol 11, no. 4 (December 2012): 171–76. https://doi.org/10.1097/HPC.0b013e31826f367f.
Fesmire FM, Buchheit RC, Cao Y, Severance HW, Jang Y, Heath GW. Risk stratification in chest pain patients undergoing nuclear stress testing: the Erlanger Stress Score. Crit Pathw Cardiol. 2012 Dec;11(4):171–6.
Fesmire, Francis M., et al. “Risk stratification in chest pain patients undergoing nuclear stress testing: the Erlanger Stress Score.Crit Pathw Cardiol, vol. 11, no. 4, Dec. 2012, pp. 171–76. Pubmed, doi:10.1097/HPC.0b013e31826f367f.
Fesmire FM, Buchheit RC, Cao Y, Severance HW, Jang Y, Heath GW. Risk stratification in chest pain patients undergoing nuclear stress testing: the Erlanger Stress Score. Crit Pathw Cardiol. 2012 Dec;11(4):171–176.

Published In

Crit Pathw Cardiol

DOI

EISSN

1535-2811

Publication Date

December 2012

Volume

11

Issue

4

Start / End Page

171 / 176

Location

United States

Related Subject Headings

  • Sensitivity and Specificity
  • Risk Factors
  • Risk Assessment
  • Retrospective Studies
  • Predictive Value of Tests
  • Myocardial Perfusion Imaging
  • Middle Aged
  • Male
  • Logistic Models
  • Humans