ArticleAmerican heart journal2012
Downstream procedures and outcomes after stress testing for chest pain without known coronary artery disease in the United States.
Article in American heart journal, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 41 citations in OpenAlex.
- Identification of Patients With Stable Chest Pain Deriving Minimal Value From Noninvasive Testing: The PROMISE Minimal-Risk Tool, A Secondary Analysis of a Randomized Clinical Trial.JAMA cardiology · 2017Trial
- Coronary CT Angiography as a Diagnostic and Prognostic Tool: Perspective from a Multicenter Randomized Controlled Trial: PROMISE.Current cardiology reports · 2016Trial
- Outcomes of anatomical versus functional testing for coronary artery disease.The New England journal of medicine · 2015Trial
- PROspective Multicenter Imaging Study for Evaluation of chest pain: rationale and design of the PROMISE trial.American heart journal · 2014Trial
- Downstream invasive coronary procedures following PET Versus SPECT myocardial perfusion imaging: a propensity-matched analysis.European journal of nuclear medicine and molecular imaging · 2026Article
- Risk Stratification of Acute Chest Pain in Patients With High-Sensitivity Troponin T Below the 99th Percentile: A Long-Term Cohort Study Assessing the Incremental Value of Necrosis and Non-necrosis Biomarkers to Clinical Risk Scores.Journal of the American Heart Association · 2025Observational
- Cross-institutional validation of a polar map-free 3D deep learning model for obstructive coronary artery disease prediction using myocardial perfusion imaging: insights into generalizability and bias.European journal of nuclear medicine and molecular imaging · 2025Article
- Pretransplant cardiac stress testing and transplant wait time in kidney transplantation candidates.Open heart · 2024Article
- Heart Rate Recovery as a Predictor of Long-Term Adverse Events after Negative Exercise Testing in Patients with Chest Pain and Pre-Test Probability of Coronary Artery Disease from 15% to 65.Diagnostics (Basel, Switzerland) · 2023Article
- Non-traditional factors affecting referral for coronary angiography following SPECT myocardial perfusion imaging.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2022Article
- Review
- Cardiac Noninvasive Diagnostic Testing for Outpatient Chest Pain: Rethinking "Less Is More".Journal of the American Heart Association · 2020Article
- Observational
- Limited Use of Outpatient Stress Testing in Young Patients With Atypical Chest Pain.Federal practitioner : for the health care professionals of the VA, DoD, and PHS · 2018Article
- Clinical Outcomes After Cardiac Stress Testing Among US Patients Younger Than 65 Years.Journal of the American Heart Association · 2018Observational
- High-Sensitivity Cardiac Troponin I and the Diagnosis of Coronary Artery Disease in Patients With Suspected Angina Pectoris.Circulation. Cardiovascular quality and outcomes · 2018Article
- Appropriateness vs value: Echocardiography in primary care.Clinical cardiology · 2017Article
- Diagnostic Strategies for the Evaluation of Chest Pain: Clinical Implications From SCOT-HEART and PROMISE.Journal of the American College of Cardiology · 2016Review
- False-Positive Stress Echocardiograms: A Continuing Challenge.Ochsner journal · 2016Review
- Value of Exercise ECG for Risk Stratification in Suspected or Known CAD in the Era of Advanced Imaging Technologies.JACC. Cardiovascular imaging · 2015Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundMillions of Americans with suspected coronary artery disease undergo noninvasive cardiac stress testing annually. Downstream procedures and subsequent outcomes among symptomatic patients without known coronary disease referred for stress testing are not well characterized in contemporary community practice.
methodsWe examined administrative insurance billing data from a national insurance provider from November 2004 through June 2007. After excluding patients with prior cardiac disease or chest pain evaluation, we identified 80,676 people age 40 to 64 years with outpatient cardiac stress testing within 30 days after an office visit for chest pain. We evaluated rates of invasive coronary angiography, coronary revascularization, and cardiovascular events after stress testing.
resultsWithin 60 days, only 8.8% of stress test patients underwent cardiac catheterization and only 2.7% underwent revascularization; within 1 year, only 0.5% died and had myocardial infarction or stroke. There were marked geographic variations in 1-year rates of catheterization (3.8%-14.8%) and revascularization (1.2%-3.0%) across 20 hospital referral regions.
conclusionsIn this large national cohort of middle-aged patients without previously coded cardiac diagnosis who were referred for stress testing after outpatient chest pain evaluation, few proceeded to invasive angiography or revascularization, and subsequent cardiovascular events were infrequent.
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.