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Comparison of two strategies in a chest pain unit: stress echocardiography and multidetector computed tomography.

Authors
  • Piñeiro-Portela, Miriam1
  • Peteiro-Vázquez, Jesús2
  • Bouzas-Mosquera, Alberto2
  • Martínez-Ruiz, Dolores2
  • Yañez-Wonenburger, Juan Carlos2
  • Pombo, Francisco3
  • Vázquez-Rodríguez, José Manuel2
  • 1 Unidad de Imagen Cardiaca, Servicio de Cardiología, Hospital Universitario A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain. Electronic address: [email protected] , (Spain)
  • 2 Unidad de Imagen Cardiaca, Servicio de Cardiología, Hospital Universitario A Coruña (CHUAC), Instituto de Investigación Biomédica de A Coruña (INIBIC), A Coruña, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain. , (Spain)
  • 3 Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Radiología, Hospital Universitario de A Coruña, A Coruña, Spain. , (Spain)
Type
Published Article
Journal
Revista espanola de cardiologia (English ed.)
Publication Date
Jan 01, 2021
Volume
74
Issue
1
Pages
59–64
Identifiers
DOI: 10.1016/j.rec.2020.01.023
PMID: 32402688
Source
Medline
Keywords
Language
Spanish
License
Unknown

Abstract

This study aimed to compare stress echocardiography (SE) and multidetector computed tomography (MCT) in patients admitted to a chest pain unit to detect acute coronary syndrome (ACS). A total of 203 patients with ≥ 1 cardiovascular risk factor, no ischemic electrocardiogram changes and negative biomarkers were randomized to SE (n=103) or MTC (n=100). The primary endpoint was a combination of hard events (death and nonfatal myocardial infarction), revascularizations, and readmissions during follow-up. The secondary endpoint was the cost of the 2 strategies. Invasive angiography was performed in 61 patients (34 [33%] in the SE group and in 27 [27%] in the MCT group, P=.15). A final diagnosis of ACS was made in 53 patients (88% vs 85%, P=.35). There were no significant differences between groups in the primary endpoint (42% vs 41%, P=.91), or in hard events (5% vs 7%, P=.42). There were no significant differences in overall cost, but costs were lower in patients with negative SE than in those with negative MCT (€557 vs €706, P <.02). No significant differences were found in efficacy and safety for the stratification of patients with a low to moderate probability of ACS admitted to a chest pain unit. The cost of the 2 strategies was similar, but cost was significantly lower for SE on comparison of negative studies. Copyright © 2020 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

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