ArticleClinical cardiology2019
Effective combination of isolated symptom variables to help stratifying acute undifferentiated chest pain in the emergency department.
Article in Clinical cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Acute Coronary Syndrome Risk Prediction Using Portable Cable-Free ECG Device Combined With Clinical Risk Assessment.JACC. Advances · 2026Article
- The Role of Using HEART Score to Risk Stratify Chest Pain Among Emergency Department High Utilizers.High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension · 2021Observational
- Evaluation and comparison of six GRACE models for the stratification of undifferentiated chest pain in the emergency department.BMC cardiovascular disorders · 2020Observational
- Effective combination of isolated symptom variables to help stratifying acute undifferentiated chest pain in the emergency department.Clinical cardiology · 2019Article
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9 authors.
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Abstract
backgroundSymptom is still indispensable for the stratification of chest pain in the emergency department. However, it is a sophisticated aggregation of several aspects of characteristics and effective combination of those variables remains deficient. We aimed to develop and validate a chest pain symptom score (CPSS) to address this issue. HYPOTHESIS: The CPSS may help stratifying acute undifferentiated chest pain in ED.
methodsPatients with non-ST segment elevation chest pain and negative cardiac troponin (cTn) over 3 hours after symptom onset were consecutively recruited as the derivation cohort. Logistic regression analyses identified statistical predictors from all symptom aspects for 30-day acute myocardial infarction (AMI) or death. The performance of CPSS was compared with the symptom classification methods of the history variable in the history, electrocardiograph, age, risk factors, troponin (HEART) score. This new model was validated in a separated cohort of patients with negative cTn within 3 hours.
resultsSeven predictors in four aspects of chest pain symptom were identified. The CPSS was an independent predictor for 30-day AMI or death (P < 0.001). In the derivation (n = 1434) and validation (n = 976) cohorts, the expected and observed event rates were well calibrated (Hosmer-Lemeshow test P > 0.30), and the c-statistics of CPSS were 0.72 and 0.73, separately, significantly better than the previous history classifications in HEART score (P < 0.001). Replacing the history variable with the CPSS improved the discrimination and risk classification of HEART score significantly (P < 0.001).
conclusionsThe effective combination of isolated variables was meaningful to make the most stratification value of symptoms. This model should be considered as part of a comprehensive strategy for chest pain triage.
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