Are there symptom differences in patients with coronary artery disease presenting to the ED ultimately diagnosed with or without ACS?

Pelter, MM; Riegel, B; McKinley, S; Moser, DK; Doering, LV; Meischke, H; Davidson, P; Baker, H; Yang, W; Dracup, K

Are there symptom differences in patients with coronary artery disease presenting to the ED ultimately diagnosed with or without ACS?

Pelter, MM Riegel, B McKinley, S Moser, DK Doering, LV Meischke, H Davidson, P

Baker, H Yang, W Dracup, K

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Publication Type:: Journal Article
Citation:: American Journal of Emergency Medicine, 2012, 30 (9), pp. 1822 - 1828
Issue Date:: 2012-11-01

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Field	Value	Language
dc.contributor.author	Pelter, MM	en_US
dc.contributor.author	Riegel, B	en_US
dc.contributor.author	McKinley, S	en_US
dc.contributor.author	Moser, DK	en_US
dc.contributor.author	Doering, LV	en_US
dc.contributor.author	Meischke, H	en_US
dc.contributor.author	Davidson, P https://orcid.org/0000-0003-2050-1534	en_US
dc.contributor.author	Baker, H	en_US
dc.contributor.author	Yang, W	en_US
dc.contributor.author	Dracup, K	en_US
dc.date.available	2012-03-03	en_US
dc.date.issued	2012-11-01	en_US
dc.identifier.citation	American Journal of Emergency Medicine, 2012, 30 (9), pp. 1822 - 1828	en_US
dc.identifier.issn	0735-6757	en_US
dc.identifier.uri	http://hdl.handle.net/10453/32203
dc.description.abstract	Objectives: Symptoms are compared among patients with coronary artery disease (CAD) admitted to the emergency department with or without acute coronary syndrome (ACS). Sex and age are also assessed. Methods: A secondary analysis from the PROMOTION (Patient Response tO Myocardial Infarction fOllowing a Teaching Intervention Offered by Nurses) trial, an multicenter randomized controlled trial, was conducted. Results: Of 3522 patients with CAD, at 2 years, 565 (16%) presented to the emergency department, 234 (41%) with non-ACS and 331 (59%) with ACS. Shortness of breath (33% vs 25%, P =.028) or dizziness (11% vs 3%, P =.001) were more common in non-ACS. Chest pain (65% vs 77%, P =.002) or arm pain (9% vs 21%, P =.001) were more common in ACS. In men without ACS, dizziness was more common (11% vs 2%; P =.001). Men with ACS were more likely to have chest pain (78% vs 64%; P =.003); both men and women with ACS more often had arm pain (men, 19% vs 10% [P =.019]; women, 26% vs 13% [P =.023]). In multivariate analysis, patients with shortness of breath (odds ratio [OR], 0.617 [confidence interval [CI], 0.410-0.929]; P =.021) or dizziness (OR,.0311 [CI, 0.136-0.708]; P =.005) were more likely to have non-ACS. Patients with prior percutaneous coronary intervention (OR, 1.592 [CI, 1.087-2.332]; P =.017), chest pain (OR, 1.579 [CI, 1.051-2.375]; P =.028), or arm pain (OR, 1.751 [CI, 1.013-3.025]; P <.042) were more likely to have ACS. Conclusions: In patients with CAD, shortness of breath and dizziness are more common in non-ACS, whereas prior percutaneous coronary intervention and chest or arm pain are important factors to include during ACS triage. © 2012 Elsevier Inc. All rights reserved.	en_US
dc.relation.ispartof	American Journal of Emergency Medicine	en_US
dc.relation.isbasedon	10.1016/j.ajem.2012.03.002	en_US
dc.subject.classification	Emergency & Critical Care Medicine	en_US
dc.subject.mesh	Arm	en_US
dc.subject.mesh	Humans	en_US
dc.subject.mesh	Dyspnea	en_US
dc.subject.mesh	Pain	en_US
dc.subject.mesh	Dizziness	en_US
dc.subject.mesh	Chest Pain	en_US
dc.subject.mesh	Retrospective Studies	en_US
dc.subject.mesh	Age Factors	en_US
dc.subject.mesh	Sex Factors	en_US
dc.subject.mesh	Aged	en_US
dc.subject.mesh	Emergency Service, Hospital	en_US
dc.subject.mesh	Female	en_US
dc.subject.mesh	Male	en_US
dc.subject.mesh	Coronary Artery Disease	en_US
dc.subject.mesh	Acute Coronary Syndrome	en_US
dc.title	Are there symptom differences in patients with coronary artery disease presenting to the ED ultimately diagnosed with or without ACS?	en_US
dc.type	Journal Article
utslib.citation.volume	9	en_US
utslib.citation.volume	30	en_US
utslib.for	1103 Clinical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Faculty of Health/Nursing
utslib.copyright.status	closed_access
pubs.issue	9	en_US
pubs.publication-status	Published	en_US
pubs.volume	30	en_US

Abstract:

Objectives: Symptoms are compared among patients with coronary artery disease (CAD) admitted to the emergency department with or without acute coronary syndrome (ACS). Sex and age are also assessed. Methods: A secondary analysis from the PROMOTION (Patient Response tO Myocardial Infarction fOllowing a Teaching Intervention Offered by Nurses) trial, an multicenter randomized controlled trial, was conducted. Results: Of 3522 patients with CAD, at 2 years, 565 (16%) presented to the emergency department, 234 (41%) with non-ACS and 331 (59%) with ACS. Shortness of breath (33% vs 25%, P =.028) or dizziness (11% vs 3%, P =.001) were more common in non-ACS. Chest pain (65% vs 77%, P =.002) or arm pain (9% vs 21%, P =.001) were more common in ACS. In men without ACS, dizziness was more common (11% vs 2%; P =.001). Men with ACS were more likely to have chest pain (78% vs 64%; P =.003); both men and women with ACS more often had arm pain (men, 19% vs 10% [P =.019]; women, 26% vs 13% [P =.023]). In multivariate analysis, patients with shortness of breath (odds ratio [OR], 0.617 [confidence interval [CI], 0.410-0.929]; P =.021) or dizziness (OR,.0311 [CI, 0.136-0.708]; P =.005) were more likely to have non-ACS. Patients with prior percutaneous coronary intervention (OR, 1.592 [CI, 1.087-2.332]; P =.017), chest pain (OR, 1.579 [CI, 1.051-2.375]; P =.028), or arm pain (OR, 1.751 [CI, 1.013-3.025]; P <.042) were more likely to have ACS. Conclusions: In patients with CAD, shortness of breath and dizziness are more common in non-ACS, whereas prior percutaneous coronary intervention and chest or arm pain are important factors to include during ACS triage. © 2012 Elsevier Inc. All rights reserved.

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http://hdl.handle.net/10453/32203