Evidence map›Paper›PMID 29374373›Full record

ArticleJournal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology2019

Utilization of stress testing for low-risk patients with chest discomfort in the emergency department.

Sheela Krishnan, Rachael Venn, Daniel M Blumenthal, Vijeta Bhambhani, Henry Gewirtz, Rory B Weiner, John T Nagurney, Jason H Wasfy

Abstract read
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In one paragraph

Article in Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 7 citations in OpenAlex.

  1. Provocative testing for low-risk chest pain patients, must we continue?Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2019
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Sheela KrishnanDivision of Cardiovascular Medicine, Department of Medicine, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. sheela.krishnan@uphs.upenn.edu.
Rachael VennDepartment of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
Daniel M BlumenthalCardiology Division, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Yawkey 5B, Boston, MA, 02114, USA.
Vijeta BhambhaniCardiology Division, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Yawkey 5B, Boston, MA, 02114, USA.
Henry GewirtzCardiology Division, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Yawkey 5B, Boston, MA, 02114, USA.
Rory B WeinerCardiology Division, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Yawkey 5B, Boston, MA, 02114, USA.
John T NagurneyDepartment of Emergency Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.
Jason H WasfyCardiology Division, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, 55 Fruit Street, Yawkey 5B, Boston, MA, 02114, USA.
Massachusetts General Hospital · USHarvard University · USHospital of the University of Pennsylvania · US

Funding

Harvard Clinical and Translational Science CenterKL2TR001100 · NCATS · HARVARD MEDICAL SCHOOL · PI NADLER, LEE MARSHALL · 2013 to 2017
$8.5M
NCATS NIH HHS KL2 TR001100
6 · The paper itself

Abstract

backgroundThe management of patients presenting to an emergency department with chest discomfort at low-risk for acute coronary syndrome represents a common clinical challenge. Such patients are often triaged to chest pain units for monitoring and cardiac stress testing for further risk stratification.

methodsWe conducted a retrospective study of 292 low-risk patients who presented to an emergency department with chest discomfort. We performed physician-adjudicated chart reviews of all patients with positive stress tests to assess downstream testing, subsequent coronary revascularization, and outcomes.

resultsOf the 292 patients, 33 (11.3%) had stress tests positive for ischemia, and 12 (4.1%) underwent diagnostic cardiac catheterization. Of the 292 patients, 4 (1.4%) underwent coronary revascularization that may have resulted in a mortality benefit.

conclusionThese data suggest a very low yield of detecting clinically significant coronary disease with stress testing low-risk patients with chest discomfort in emergency department chest pain units.

Indexed as

Emergency Service, HospitalExercise TestAcute Coronary SyndromeAgedChest PainCoronary Artery DiseaseEmergency MedicineFemaleHumansMaleMiddle AgedMyocardial Perfusion ImagingProspective StudiesRetrospective StudiesRiskRisk Assessmentdiagnostic and prognostic applicationexercise: stress testingIschemiamyocardialmyocardial perfusion imaging: SPECTpharmacologic stress

Identifiers

PMID29374373
OpenAlexW2791488482

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.