How to Trip Rapid Review

Step 1: Select articles relevant to your search (remember the system is only optimised for single intervention studies)

Step 2: press

Step 3: review the result, and maybe amend the or if you know better! If we're unsure of the overall sentiment of the trial we will display the conclusion under the article title. We then require you to tell us what the correct sentiment is.

793 results for

Coronary Risk Stratification of Chest Pain

by
...
Alerts

Export results

Use check boxes to select individual results below

SmartSearch available

Trip's SmartSearch engine has discovered connected searches & results. Click to show

61. CT coronary angiography: new risks for low-risk chest pain. (PubMed)

CT coronary angiography: new risks for low-risk chest pain. Widespread conservative management of low-risk chest pain has motivated the development of a rapid triage strategy based on CT coronary angiography (CTCA) in the Emergency Department (ED). Recently, three prominent trials using this technology in the ED setting have presented results in support of its routine use. However, these studies fail to show the incremental prognostic value of CTCA over clinical and biomarker-based risk (...) -stratification strategies, demonstrate additional downstream costs and interventions, and result in multiple harms associated with radio-contrast and radiation exposure. Observing the widespread overdiagnosis of pulmonary embolism following availability of CT pulmonary angiogram as a practice pattern parallel, CTCA use for low-risk chest pain in the ED should be advanced only with caution.

2012 Emergency Medicine Journal

62. Non-invasive assessment of low- and intermediate-risk patients with chest pain (PubMed)

Non-invasive assessment of low- and intermediate-risk patients with chest pain Coronary artery disease (CAD) remains a significant global public health burden despite advancements in prevention and therapeutic strategies. Common non-invasive imaging modalities, anatomic and functional, are available for the assessment of patients with stable chest pain. Exercise electrocardiography is a long-standing method for evaluation for CAD and remains the initial test for the majority of patients who can (...) - and intermediate-risk patients with chest pain, where no single study is suitable for all patients. This review will describe currently available non-invasive modalities, along with current evidence-based guidelines and appropriate use criteria in the assessment of low- and intermediate-risk patients with suspected, stable CAD.Copyright © 2017 Elsevier Inc. All rights reserved.

Full Text available with Trip Pro

2016 Trends in cardiovascular medicine

63. Best Clinical Practice: Current Controversies in Evaluation of Low-Risk Chest Pain-Part 1. (PubMed)

risk, nor do they diagnose acute MI. CCTA is an anatomic evaluation of the coronary vasculature with literature support to decrease ED length of stay, though it is associated with downstream testing. Literature is controversial concerning further risk stratification in already low-risk patients.With nonischemic ECG and negative cardiac biomarker, the risk of ACS approaches < 1%. Use of stress test and CCTA for risk stratification of low-risk chest pain patients is controversial. These tests may (...) Best Clinical Practice: Current Controversies in Evaluation of Low-Risk Chest Pain-Part 1. Chest pain is a common presentation to the emergency department (ED), though the majority of patients are not diagnosed with acute coronary syndrome (ACS). Many patients are admitted to the hospital due to fear of ACS.Our aim was to investigate controversies in low-risk chest pain evaluation, including risk of missed ACS, stress test, and coronary computed tomography angiography (CCTA).Chest pain accounts

2016 Journal of Emergency Medicine

64. Does Coronary Artery Calcium Scoring Add to the Predictive Value of Coronary Computed Tomography Angiography for Adverse Cardiovascular Events in Low-risk Chest Pain Patients? (PubMed)

Does Coronary Artery Calcium Scoring Add to the Predictive Value of Coronary Computed Tomography Angiography for Adverse Cardiovascular Events in Low-risk Chest Pain Patients? Coronary angiography calcium score (CACS) is included for patients who receive coronary computed tomography angiography (CTA) as part of diagnostic testing for low-risk chest pain. Both tests add radiation exposure, and it is unclear whether the combination provides more information than either test alone. The objective (...) was to asses if CACS = 0 determines freedom from coronary artery disease (CAD) and whether the addition of CACS to coronary CT angiography provides additional risk stratification information or helps predict 30-day cardiovascular outcomes.This was a secondary analysis of a prospective cohort study at an urban university hospital emergency department (ED), of patients with symptoms suggestive of potential acute coronary syndrome (ACS) and low Thrombolysis in Myocardial Infarction (TIMI) risk scores who

Full Text available with Trip Pro

2011 Academic Emergency Medicine

65. Prospective validation of Thrombolysis in Myocardial Infarction and front door Thrombolysis in Myocardial Infarction risk scores in Chinese patients presenting to the ED with chest pain. (PubMed)

for TIMI0 to 37.5% for patients with TIMI6/7. Increasing TIMI and FDTIMI scores were associated with a higher incidence of MACE.This validation suggests that the TIMI/FDTIMI scores can be employed in Hong Kong Chinese; they may be useful for risk stratification of Chinese ED patients with undifferentiated chest pain elsewhere.Copyright © 2014 Elsevier Inc. All rights reserved. (...) Prospective validation of Thrombolysis in Myocardial Infarction and front door Thrombolysis in Myocardial Infarction risk scores in Chinese patients presenting to the ED with chest pain. Chest pain is a common complaint among emergency department (ED) patients. The Thrombolysis in Myocardial Infarction (TIMI) and front door TIMI (FDTIMI) scores are used to risk stratify chest pain patients in many Western countries; they have not been validated in patients with undifferentiated chest pain

2014 American Journal of Emergency Medicine

66. Chest Pain

, Precordial Pain From Related Chapters II. Risk Factors See s See III. Epidemiology Acute and Chest Pain are the two most commonly litigated ED claims IV. Precautions No single finding is absolutely pathognomonic nor completely reassuring in Chest Pain presentation Risk stratification, evaluation and management is based on an overall analysis of all clinical data Approach should be based on combination of factors Exam, ekg and s Consider atypical presentations of coronary syndromes in atypical patients (...) Chest Pain Chest Pain Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Chest Pain Chest Pain Aka: Chest Pain , Chest Pain Causes

2018 FP Notebook

67. Novel Biomarkers: Utility in Patients with Acute Chest Pain and Relationship to Coronary Artery Disease on Coronary CT Angiography (PubMed)

Novel Biomarkers: Utility in Patients with Acute Chest Pain and Relationship to Coronary Artery Disease on Coronary CT Angiography Acute chest pain remains one of the most common patient presentations encountered in the emergency department. With the evolution of biomarkers and improvement in cardiac imaging there has been advancement in risk stratification of patients, but millions of dollars continue to be spent in the assessment of chest pain. Investigators have explored possible comparative (...) alternatives to the traditional work up of chest pain. In this review, we will discuss the current state of biomarker use in the evaluation of acute chest pain. We will review established and emerging circulating biomarkers and their addition to cardiac CT for appropriate diagnosis of coronary artery disease.

Full Text available with Trip Pro

2014 Current cardiovascular imaging reports

68. Primary Care Corner with Geoffrey Modest MD: Chest pain prediction tool

these patients as low risk and eligible for early discharge. Commentary: –only 20% of patients coming to the ED with chest pain have acute coronary syndrome. But one of the difficulties is that about 50% with acute coronary syndrome do not have classic symptoms. And 2-6% of patients with acute coronary syndrome are missed by current practice. –Overall in the Netherlands (and other countries), management is conservative and 2/3 of the patients with chest pain get admitted. So, this study adds to the data (...) Primary Care Corner with Geoffrey Modest MD: Chest pain prediction tool Primary Care Corner with Geoffrey Modest MD: Chest pain prediction tool | BMJ EBM Spotlight by by Dr Geoffrey Modest The second article on the ED evaluation of chest pain involved an instrument to predict/stratify cardiac risk, finding it to be quick, reliable and efficient (see doi:10.7326/M16-1600). Details: –Nine Dutch hospitals assessed the HEART instrument prospectively to evaluate unselected patients presenting to EDs

2017 Evidence-Based Medicine blog

69. Sepsis as an important risk factor for gastrointestinal bleeding in acute coronary syndrome patients: Two case reports. (PubMed)

by authoritative guidelines for acute coronary syndrome (ACS), does not include sepsis as a bleeding risk factor.The 2 cases were about ACS with hemorrhagic complications. The first patient was an 88-year-old man with hypertension, gallstones, hepatic cysts, and chest pain; the second one was a 79-year-old man with chest pain and hypertension. These 2 ACS patients had no bleeding on admission; however, both patients suffered apparent gastrointestinal bleeding immediately after the development of sepsis (...) Sepsis as an important risk factor for gastrointestinal bleeding in acute coronary syndrome patients: Two case reports. Sepsis is a common stressor that may decrease microcirculation in the gastrointestinal tract in patients and increase the gastrointestinal bleeding risk of stress-related mucosal disease. However, the CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines) bleeding risk score, recommended

Full Text available with Trip Pro

2018 Medicine

70. Guidelines on Chronic Coronary Syndromes

Prospective Multicenter Imaging Study for Evaluation of Chest Pain PTP Pre-test probability RAS Renin−angiotensin system RCT Randomized clinical trial REACH Reduction of Atherothrombosis for Continued Health RIVER-PCI Ranolazine for Incomplete Vessel Revascularization Post‐Percutaneous Coronary Intervention SCORE Systematic COronary Risk Evaluation SCOT- HEART Scottish Computed Tomography of the HEART SIGNIFY Study Assessing the Morbidity–Mortality Benefits of the If Inhibitor Ivabradine in Patients (...) revascularization 38 5.2 Patients >1 year after initial diagnosis or revascularization 38 6. Angina without obstructive disease in the epicardial coronary arteries 40 6.1 Microvascular angina 41 6.1.1 Risk stratification 41 6.1.2 Diagnosis 41 6.1.3 Treatment 41 6.2 Vasospastic angina 42 6.2.1 Diagnosis 42 6.2.2 Treatment 42 7. Screening for coronary artery disease in asymptomatic subjects 43 8. Chronic coronary syndromes in specific circumstances 44 8.1 Cardiovascular comorbidities 44 8.1.1 Hypertension 44

Full Text available with Trip Pro

2019 European Society of Cardiology

71. Chronic kidney disease as a risk factor for acute coronary syndromes in patients presenting to the emergency room with chest pain. (PubMed)

Chronic kidney disease as a risk factor for acute coronary syndromes in patients presenting to the emergency room with chest pain. We sought to determine whether persons with intermediate risk factors for cardiovascular disease presenting to an emergency department with chest pain and chronic kidney disease (CKD) were triaged effectively by chest pain units (CPUs). CPUs evaluate patients with intermediate risk and acute chest pain effectively. CKD is a risk factor for poor outcomes once (...) that CKD is a strong predictor of hospitalization and overall long-term mortality in patients presenting with chest pain to the emergency department. Current risk factor stratification scoring systems should consider CKD as a predictor of increased risk in patients with chest pain.Copyright © 2012. Published by Mosby, Inc.

2012 Translational research : the journal of laboratory and clinical medicine

72. Cardiac arrhythmias in coronary heart disease

assessment of LV function for risk stratification at least six weeks following the acute event. 2.3 ARRHYTHMIAS ASSOCIATED WITH CHRONIC CORONARY HEART DISEASE/LEFT VENTRICULAR DYSFUNCTION R Rate control is the recommended strategy for management of patients with well-tolerated atrial fibrillation. R In patients with permanent AF or persistent AF following a rate-control strategy and a resting heart rate >110 bpm, appropriate rate-control therapy should be instituted with an initial target of resting (...) artery bypass graft surgery 29 6.1 Introduction 29 6.2 Risk factors 29 6.3 Prophylactic interventions 29 6.4 Treatments for atrial fibrillation 32 6.5 Treatments for ventricular arrhythmias 34 6.6 Preoperative information 35 7 Psychosocial issues 36 7.1 Introduction 36 7.2 Psychosocial assessment and screening 36 7.3 Psychosocial issues for ICD recipients 37 7.4 Psychosocial interventions 37 7.5 Antidepressant medications in patients with coronary heart disease 38 8 Provision of information 39 8.1

2018 SIGN

73. Modified TIMI risk score cannot be used to identify low-risk chest pain in the emergency department: a multicentre validation study. (PubMed)

Modified TIMI risk score cannot be used to identify low-risk chest pain in the emergency department: a multicentre validation study. The Thrombolysis in Myocardial Infarction (TIMI) risk score (range 0-7), used for emergency department (ED) risk stratification of patients with suspected acute coronary syndrome (ACS), underestimates risk associated with ECG changes or cardiac troponin elevation. A modified TIMI score (mTIMI, range 0-10), which gives increased weighting to these variables, has (...) ) for standard TIMI, respectively.mTIMI score performs better than standard TIMI score for ED risk stratification of chest pain, but neither is sufficiently sensitive at scores >0 to allow safe and early discharge without further investigation or follow-up. Observed differences in performance may be due to incorporation bias.

2013 Emergency Medicine Journal

74. Machine learning of clinical variables and coronary artery calcium scoring for the prediction of obstructive coronary artery disease on coronary computed tomography angiography: analysis from the CONFIRM registry. (PubMed)

Machine learning of clinical variables and coronary artery calcium scoring for the prediction of obstructive coronary artery disease on coronary computed tomography angiography: analysis from the CONFIRM registry. Symptom-based pretest probability scores that estimate the likelihood of obstructive coronary artery disease (CAD) in stable chest pain have moderate accuracy. We sought to develop a machine learning (ML) model, utilizing clinical factors and the coronary artery calcium score (CACS (...) for all comparisons. CACS, age, and gender were the highest ranking features.A ML model incorporating clinical features in addition to CACS can accurately estimate the pretest likelihood of obstructive CAD on CCTA. In clinical practice, the utilization of such an approach could improve risk stratification and help guide downstream management.Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: journals.permissions@oup.com.

Full Text available with Trip Pro

2019 European Heart Journal

75. Diagnostic yield of coronary angiography in patients with acute chest pain: role of noninvasive test. (PubMed)

Diagnostic yield of coronary angiography in patients with acute chest pain: role of noninvasive test. This study investigated the diagnostic yield of invasive coronary angiography (CAG) and the impact of noninvasive test (NIV) in patients presented to emergency department (ED) with acute chest pain.Patients 50 years or older who visited ED with acute chest pain and underwent CAG were identified retrospectively. Those with ischemic electrocardiogram, elevated cardiac enzyme, known coronary (...) = .026] for detection of CAD; 45.0% vs 50.5% [P = .285] for revascularization). Positive results of NIV were significantly associated with the presence of CAD and the need for revascularization, when compared with patients without NIV or patients with negative results (P < .001, respectively).The diagnostic yield of CAG was only 65% in low- to intermediate-risk ED patients with acute chest pain. Performing of NIV provided only modest improvement in diagnostic yield of CAG. The unexpectedly low

2013 American Journal of Emergency Medicine

76. Evaluation and outcomes of patients admitted to a tertiary medical assessment unit with acute chest pain of possible coronary origin. (PubMed)

Evaluation and outcomes of patients admitted to a tertiary medical assessment unit with acute chest pain of possible coronary origin. The study aims to (i) profile clinical characteristics, risk estimates of acute coronary syndrome (ACS), use and yield of non-invasive cardiac testing, discharge diagnosis and 30-day outcomes among patients admitted with acute chest pain of possible coronary origin; and (ii) construct a risk stratification algorithm that informs management decisions.This (...) is a retrospective cohort study of 130 consecutive patients admitted to a tertiary hospital medical assessment unit between 24 January and 22 March 2012. Estimates of ACS risk were based on Australian guidelines and Thrombolysis in Myocardial Infarction (TIMI) scores.Patients were of mean age 61 years, 45% had known coronary artery disease (CAD), 58% presented with typical ischaemic pain, 82% had intermediate to high ACS risk and 61% underwent testing. Myocardial ischaemia was cardiologist-confirmed discharge

2013 Emergency medicine Australasia

77. Increased urinary IgM excretion in patients with chest pain due to coronary artery disease. (PubMed)

 mg/mmol) had a 3-fold higher risk for cardiovascular new events compared to patients with low IgM-uria (RR = 3.3, 95% CI: 1.1 - 9.9, p = 0.001).In patients with chest pain, an increased urine IgM excretion, is associated with coronary artery disease and long-term cardiovascular complications. Measuring urine IgM concentration could have a clinical value in risk stratification of patients with ACS. (...) Increased urinary IgM excretion in patients with chest pain due to coronary artery disease. Micro-albuminuria is a recognized predictor of cardiovascular morbidity and mortality in patients with coronary artery disease. We have previously reported, in diabetic and non-diabetic patients, that an increased urinary excretion of IgM is associated with higher cardiovascular mortality. The purpose of this study was to investigate the pattern of urinary IgM excretion in patients with acute coronary

Full Text available with Trip Pro

2013 BMC Cardiovascular Disorders

78. Are Serial Electrocardiograms Additive to SeriAl Second-generations Troponins in Predicting Acute CoronAry Syndromes in PatienTs With Undifferentiated cHest Pain

: February 2018 Keywords provided by Wake Forest University Health Sciences: Acute Coronary Syndrome Chest pain Electrocardiograms Risk Stratification Emergency Department Additional relevant MeSH terms: Layout table for MeSH terms Syndrome Acute Coronary Syndrome Chest Pain Disease Pathologic Processes Myocardial Ischemia Heart Diseases Cardiovascular Diseases Vascular Diseases Pain Neurologic Manifestations Signs and Symptoms (...) electrocardiogram (ECG) changes aids in reclassifying participants' risk for major adverse cardiac events (MACE) over and above serial blood testing. Condition or disease Intervention/treatment Acute Coronary Syndrome Chest Pain Device: Serial Electrocardiograms Detailed Description: Chest pain is one of the most common symptoms evaluated in the Emergency Department (ED). One of the primary diagnostic concerns during the evaluation of this presentation is whether there is evidence of acute coronary syndromes

2013 Clinical Trials

79. Diagnostic importance of admission platelet volume indices in patients with acute chest pain suggesting acute coronary syndrome (PubMed)

be of benefit to detect chest pain resulting in MI from that of non-cardiac one, and also for risk stratification of patients who suffered from an acute chest discomfort.Copyright © 2014 Cardiological Society of India. Published by Elsevier B.V. All rights reserved. (...) Diagnostic importance of admission platelet volume indices in patients with acute chest pain suggesting acute coronary syndrome Acute coronary syndrome (ACS) is a challenging issue in cardiovascular medicine. Given platelet role in atherothrombosis, we sought to determine whether platelet indices can be used as diagnostic tests for patients who suffered from an acute chest discomfort.We prospectively enrolled 862 patients with an acute chest pain and 184 healthy matched controls. They were

Full Text available with Trip Pro

2014 Indian heart journal

80. Asymptomatic Patient at Risk for Coronary Artery Disease

Assoc Radiol J. 2009;60(1):19-34. 27. Greenland P, Bonow RO, Brundage BH, et al. ACCF/AHA 2007 clinical expert consensus document on coronary artery calcium scoring by computed tomography in global cardiovascular risk assessment and in evaluation of patients with chest pain: a report of the American College of Cardiology Foundation Clinical Expert Consensus Task Force (ACCF/AHA Writing Committee to Update the 2000 Expert Consensus Document on Electron Beam Computed Tomography) developed (...) Clinical Condition: Asymptomatic Patient at Risk for Coronary Artery Disease Variant 1: Low risk. Radiologic Procedure Rating Comments RRL* CT coronary calcium 3 In patients with strong family history, this study may be of value. ??? Fluoroscopy heart 2 ?? US echocardiography transthoracic resting 2 O X-ray chest 1 ? CTA coronary arteries with IV contrast 1 ??? MRI heart with stress without and with IV contrast 1 O MRI heart with stress without IV contrast 1 O MRI heart function and morphology without

2013 American College of Radiology

To help you find the content you need quickly, you can filter your results via the categories on the right-hand side >>>>