Evidence map›Paper›PMID 41381590›Full record

Observational studyScientific reports2025

An Australian experience of the Rapid Access Chest Pain Assessment Clinic.

Hussein Al-Fiadh, Robert Azzopardi, Marwan Shawki, Zhao Feng Liu, Yao-Chen Lin, Flona Petrus, Nicole Brisbane, Chantelle Zoumberis, Ali Al-Fiadh

Abstract readObservational Study
In one paragraph

Observational study in Scientific reports, 2025. 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
–field-weighted citation impact
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.

  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

9 authors.

Hussein Al-Fiadh *Monash University, Melbourne, VIC 3800, Australia. half0001@student.monash.edu.ORCID 0009-0006-5386-834X
Robert Azzopardi *Monash University, Melbourne, VIC 3800, Australia.
Marwan ShawkiSchool of Medicine, University of Melbourne, Melbourne, Australia.
Zhao Feng LiuMonash University, Melbourne, VIC 3800, Australia.
Yao-Chen LinSchool of Medicine, University of Melbourne, Melbourne, Australia.
Flona PetrusAustin Hospital, Melbourne, Australia.
Nicole BrisbaneAustin Hospital, Melbourne, Australia.
Chantelle ZoumberisAustin Hospital, Melbourne, Australia.
Ali Al-FiadhSchool of Medicine, University of Melbourne, Melbourne, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Rapid Access Chest Pain Assessment Clinic (RACPAC) offers an outpatient evaluation for patients with troponin-negative, low-to-intermediate risk chest pain. This 10-year study assessed its role in the early identification of patients at cardiovascular risk and compared the modes of coronary investigation performances. A single-centre, observational, retrospective cohort study from July 2012 to July 2022 assessed patients who underwent diagnostic tests: CT coronary angiography (CTCA), treadmill stress echocardiogram (TSE), myocardial perfusion scan (MPS), or invasive coronary angiogram (ICA). True positive cases were defined by obstructive disease on subsequent ICA. Baseline characteristics, investigation choice, results, conversion rates to ICA, and identification of new modifiable risk factors to potentially reduce future cardiovascular events were analysed. A total of 3976 patients with low-to-intermediate risk chest pain, mean age (55.2 ± 11.6) years, 51% male, with prevalent risk factors such as positive family history (49%) and dyslipidaemia (42%). Initial investigations: TSE (49.2%), CTCA (43.7%), MPS (4.6%), and ICA (2.5%). CTCA showed superior performance compared to TSE in positive predictive value (97% vs. 82%), negative predictive value (66% vs. 27%) for those proceeding to ICA despite initial negative/inconclusive results, and attendance rates (97% vs. 92%). Incidental findings occurred in 4% of cases, predominantly with CTCA. New modifiable CVD risk factors were identified in 33% of patients, and 17% had CAD with pre-existing CVD risk factors needing stricter control. Our study highlights the effectiveness of CTCA as a primary investigation for troponin-negative, low-to-intermediate risk chest pain patients, with high predictive values, incidental findings and attendance rates. It also emphasises RACPAC's potential role in identifying patients at cardiovascular disease risk and perhaps reducing future cardiovascular morbidity and mortality.

Indexed as

Chest PainAdultAgedAustraliaComputed Tomography AngiographyCoronary AngiographyCoronary Artery DiseaseEchocardiography, StressFemaleHumansMaleMiddle AgedMyocardial Perfusion ImagingRetrospective StudiesRisk FactorsCardiovascular disease preventionCoronary artery diseaseCT coronary angiogramDiagnostic testingModifying cardiovascular risk

Identifiers

PMID41381590
PMCPMC12699033

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

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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.