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Diagnosis

Novel protocol for risk assessment of patients with chest pain

Nature Reviews Cardiology volume 8, page 306 (2011)Cite this article

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An international team of researchers has developed and validated a 2 h diagnostic protocol to identify patients presenting with chest pain who are at low risk of experiencing a cardiac event. “Data have been published on 2 h pathways without prospective validation,” explains Dr. Martin Than, who was one of the Asia–Pacific Evaluation of Chest Pain Trial (ASPECT) investigators. “I was anxious to integrate structured pretest probability estimation into the assessment.”

Examination of patients with chest pain can be a lengthy process. The ACC/AHA guidelines recommend that cardiac troponins be measured serially over a period of at least 6 h from the onset of symptoms and many people are admitted as inpatients. In addition, these patients are often seen by junior doctors with limited experience of applying clinical risk predictors in undifferentiated populations, such as those seen in the emergency department. However, a substantial proportion of patients who undergo assessment for causes of chest pain are not diagnosed with acute coronary syndromes. Evidently, a need exists for strategies to improve the speed and accuracy of the diagnostic work-up, so as to identify very-low-risk patients who could be discharged quickly, thereby reducing hospital overcrowding and financial costs.

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ORIGINAL RESEARCH PAPER

  1. Than, M. et al. A 2-h diagnostic protocol to assess patients with chest pain symptoms in the Asia–Pacific region (ASPECT): a prospective observational validation study. Lancet doi:10.1016/S0140-6736(11)60310-3

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  1. Alexandra King
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King, A. Novel protocol for risk assessment of patients with chest pain. Nat Rev Cardiol 8, 306 (2011). https://doi.org/10.1038/nrcardio.2011.70

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  • DOI: https://doi.org/10.1038/nrcardio.2011.70

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