Evidence map›Paper›PMID 38155226›Full record

ArticleHerz2024

Cardiac, possible cardiac, and likely non-cardiac origin of chest pain : A hitherto underestimated parameter in German chest pain units.

Sebastian Imhof, Matthias Hochadel, Stavros Konstantinides, Thomas Voigtländer, Claus Schmitt, Bernd Nowak, Tienush Rassaf, Jochen Senges, Thomas Münzel, Evangelos Giannitsis and 1 more

Abstract read
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In one paragraph

Article in Herz, 2024. 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
0.5field-weighted citation impact, top 31% 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, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 2 countries.

Sebastian ImhofDepartment of Cardiology, Pneumology, Neurology and Intensive Care, Klinik Kitzinger Land, Kitzingen, Germany.
Matthias HochadelInstitute for Myocardial Infarction Research Foundation, Ludwigshafen, Germany.
Stavros KonstantinidesCenter for Thrombosis and Hemostasis (CTH), University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Thomas VoigtländerCCB, Cardioangiologisches Centrum Bethanien, Frankfurt am Main, Germany.
Claus SchmittClinic for Cardiology and Angiology, Municipal Hospital Karlsruhe, Karlsruhe, Germany.
Bernd NowakCCB, Cardioangiologisches Centrum Bethanien, Frankfurt am Main, Germany.
Tienush RassafDepartment of Cardiology and Vascular Medicine, West German Heart and Vascular Center Essen, University Duisburg-Essen, Essen, Germany.
Jochen SengesInstitute for Myocardial Infarction Research Foundation, Ludwigshafen, Germany.
Thomas MünzelDepartment of Cardiology, University Medical Center Mainz, Johannes Gutenberg-University Mainz, Mainz, Germany.
Evangelos Giannitsis3rd Department of Medicine, University Hospital Heidelberg, Heidelberg, Germany.
Frank BreuckmannDepartment of Cardiology, Pneumology, Neurology and Intensive Care, Klinik Kitzinger Land, Kitzingen, Germany. frank.breuckmann@k-kl.de.
Cardiovascular Center Bethanien · DEHeidelberg University · DEJohannes Gutenberg University Mainz · DEKlinik Hietzing · ATStädtisches Klinikum Karlsruhe · DEUniversity Medical Center of the Johannes Gutenberg University Mainz · DEWest German Heart and Vascular Center Essen · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCurrent guidelines emphasize the diagnostic value of non-cardiac or possibly cardiac chest pain. The goal of this analysis was to determine whether German chest pain units (CPUs) adequately address conditions with "atypical" chest pain in existing diagnostic structures.

methodA total of 11,734 patients from the German CPU registry were included. The analyses included mode of admission, critical time intervals, diagnostic steps, and differential diagnoses.

resultsPatients with unspecified chest pain were younger, more often female, were less likely to have classic cardiovascular risk factors and tended to present more often as self-referrals. Patients with acute coronary syndrome (ACS) mostly had prehospital medical contact. Overall, there was no difference between these two groups regarding the time from the onset of first symptoms to arrival at the CPU. In the CPU, the usual basic diagnostic measures were performed irrespective of ACS as the primary working diagnosis. In the non-ACS group, further ischemia-specific diagnostics were rarely performed. Extra-cardiac differential diagnoses were not specified.

conclusionThe establishment of broader awareness programs and opening CPUs for low-threshold evaluation of self-referring patients should be discussed. Regarding the rigid focus on the clarification of cardiac causes of chest pain, a stronger interdisciplinary approach should be promoted.

Indexed as

Chest PainAcute Coronary SyndromeAgedAge DistributionComorbidityDiagnosis, DifferentialFemaleGermanyHumansMaleMiddle AgedPrevalenceRegistriesRetrospective StudiesSex DistributionAcute coronary syndromeDifferential diagnosisInterdisciplinary health teamSymptom onsetUnderestimation

Identifiers

PMID38155226
OpenAlexW4390336021

What OpenQuestion holds

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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.