SynthesisThe British journal of general practice : the journal of the Royal College of General Practitioners2008
Signs and symptoms in diagnosing acute myocardial infarction and acute coronary syndrome: a diagnostic meta-analysis.
Synthesis in The British journal of general practice : the journal of the Royal College of General Practitioners, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02024282 (Validation of a Vital Signs and Symptoms Decision Tree and the Effect of a Point-of- Care CRP Test, Oxygen Saturation, a Brief Intervention and a Parent Leaflet on Diagnosing, Antibiotic Prescribing Rate and Parental Satisfaction in Acutely Ill Children in Primary Care."), which is not on this map. Cited by 56 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Validation of a Vital Signs and Symptoms Decision Tree and the Effect of a Point-of- Care CRP Test, Oxygen Saturation, a Brief Intervention and a Parent Leaflet on Diagnosing, Antibiotic Prescribing Rate and Parental Satisfaction in Acutely Ill Children in Primary Care."
Who cites it
56 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Prodromal Symptoms of Acute Myocardial Infarction in Women: A Systematic Review of Current Evidence.Nursing open · 2025Pooled it
- Diagnostic accuracy of signs and symptoms in acute coronary syndrome and acute myocardial infarction.Scandinavian journal of primary health care · 2025Pooled it
- Clinical assessment of patients with chest pain; a systematic review of predictive tools.BMC cardiovascular disorders · 2016Pooled it
- Chest discomfort at night and risk of acute coronary syndrome: cross-sectional study of telephone conversations.Family practice · 2020Trial
- Association of CYP2C19 Polymorphism with Clopidogrel Resistance in Patients with Acute Coronary Syndrome in China.Medical science monitor : international medical journal of experimental and clinical research · 2019Trial
- Trial
- Real-Time Integration of an AI-Based ECG Interpretation System in the Emergency Department: A Pragmatic Alternating-Day Study of Diagnostic Performance and Clinical Process Metrics.Healthcare (Basel, Switzerland) · 2026Article
- Clinical profile of acute myocardial infarction: the Registry of Acute Medical Emergencies registry.Revista da Associacao Medica Brasileira (1992) · 2026Observational
- Association Between Angina Symptom Characteristics and Obstructive Coronary Artery Disease: A Comparative Cross-Sectional Study.The journal of nursing research : JNR · 2025Article
- Risk factors associated with myocardial infarction among patients at Uganda heart institute, Mulago National referral hospital in Uganda.BMC cardiovascular disorders · 2025Article
- Awareness of Heart Attack Symptoms and Risk Factors Among the Elderly in Rural Chennai: A Cross-Sectional Study.Cureus · 2025Article
- Role of heavy sweating for ST-segment elevation myocardial infarction: analysis of the China Acute Myocardial Infarction registry.BMC cardiovascular disorders · 2025Observational
- Aptamer-Based Planar Electric Double-Layer Field-Effect Transistor: A Novel Approach for Sensitive Troponin I Sensing.Biosensors · 2025Article
- Expression ofGenes · 2024Article
- Determinants of referral for suspected coronary artery disease: a qualitative study based on decision thresholds.BMC primary care · 2023Article
- Variants TaggingGenes · 2022Article
- Development of Prediction Models for Acute Myocardial Infarction at Prehospital Stage with Machine Learning Based on a Nationwide Database.Journal of cardiovascular development and disease · 2022Article
- Broad Electrocardiogram Syndromes Spectrum: From Common Emergencies to Particular Electrical Heart Disorders.Journal of personalized medicine · 2022Review
- Article
- Cardiac biomarkers and detection methods for myocardial infarction.Molecular & cellular toxicology · 2022Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPrompt diagnosis of acute myocardial infarction or acute coronary syndrome is very important.
aimA systematic review was conducted to determine the accuracy of 10 important signs and symptoms in selected and non-selected patients. DESIGN OF STUDY: Diagnostic meta-analysis.
methodUsing MEDLINE, CINAHL, EMBASE, tracing references, and by contacting experts, studies were sought out that described one of the 10 signs and symptoms on one or both conditions. Studies were excluded if they were not based on original data. Validity was assessed using QUADAS and all data were pooled using a random effects model.
resultsSixteen of the 28 included studies were about patients who were non-selected. In this group, absence of chest-wall tenderness on palpation had a pooled sensitivity of 92% (95% confidence interval [CI] = 86 to 96) for acute myocardial infarction and 94% (95% CI = 91 to 96) for acute coronary syndrome. Oppressive pain followed with a pooled sensitivity of 60% (95% CI = 55 to 66) for acute myocardial infarction. Sweating had the highest pooled positive likelihood ratio (LR+), namely 2.92 (95% CI = 1.97 to 4.23) for acute myocardial infarction. The other pooled LR+ fluctuated between 1.05 and 1.49. Negative LRs (LR-) varied between 0.98 and 0.23. Absence of chest-wall tenderness on palpation had a LR- of 0.23 (95% CI = 0.18 to 0.29).
conclusionsBased on this meta-analysis it was not possible to define an important role for signs and symptoms in the diagnosis of acute myocardial infarction or acute coronary syndrome. Only chest-wall tenderness on palpation largely ruled out acute myocardial infarction or acute coronary syndrome in low-prevalence settings.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.