Clinical characteristics, myocardial perfusion deficits, and clinical outcomes of patients with non-specific chest pain hospitalized for suspected acute coronary syndrome: A 4-year prospective cohort study

Stochkendahl, Mette Jensen; Mickley, Hans; Vach, Werner; Aziz, Ahmed Abd El; Christensen, Henrik Wulff; Hartvigsen, Jan; Høilund‐Carlsen, Poul Flemming

doi:10.1016/j.ijcard.2014.12.054

Cited by 7 publications

(7 citation statements)

References 35 publications

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“…No validation was reported for stroke. Stochkendahl et al (2015) [ 42 ] Danish National Patient Register from 2006 to 2011 ACS, stroke, CV death, cardiac revascularization procedure ACS: I21-I23, I24.0, I24.8, I24.9; stroke: I60-I69; CV death: I00-I99 (ICD-10). (Authors did not cite ICD codes for cardiac revascularization procedures.)…”

Section: Resultsmentioning

confidence: 99%

Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review

Bosco

Hsueh

McConeghy

et al. 2021

BMC Med Res Methodol

200

113

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Background Major adverse cardiovascular events (MACE) are increasingly used as composite outcomes in randomized controlled trials (RCTs) and observational studies. However, it is unclear how observational studies most commonly define MACE in the literature when using administrative data. Methods We identified peer-reviewed articles published in MEDLINE and EMBASE between January 1, 2010 to October 9, 2020. Studies utilizing administrative data to assess the MACE composite outcome using International Classification of Diseases 9th or 10th Revision diagnosis codes were included. Reviews, abstracts, and studies not providing outcome code definitions were excluded. Data extracted included data source, timeframe, MACE components, code definitions, code positions, and outcome validation. Results A total of 920 articles were screened, 412 were retained for full-text review, and 58 were included. Only 8.6% (n = 5/58) matched the traditional three-point MACE RCT definition of acute myocardial infarction (AMI), stroke, or cardiovascular death. None matched four-point (+unstable angina) or five-point MACE (+unstable angina and heart failure). The most common MACE components were: AMI and stroke, 15.5% (n = 9/58); AMI, stroke, and all-cause death, 13.8% (n = 8/58); and AMI, stroke and cardiovascular death 8.6% (n = 5/58). Further, 67% (n = 39/58) did not validate outcomes or cite validation studies. Additionally, 70.7% (n = 41/58) did not report code positions of endpoints, 20.7% (n = 12/58) used the primary position, and 8.6% (n = 5/58) used any position. Conclusions Components of MACE endpoints and diagnostic codes used varied widely across observational studies. Variability in the MACE definitions used and information reported across observational studies prohibit the comparison, replication, and aggregation of findings. Studies should transparently report the administrative codes used and code positions, as well as utilize validated outcome definitions when possible.

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Section: Resultsmentioning

confidence: 99%

Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review

Bosco

Hsueh

McConeghy

et al. 2021

BMC Med Res Methodol

200

113

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“…The backgrounds of patients also influence cardiac event rates. For example, the incidence of cardiac events in patients with non-specific chest pain would be low, whereas those in patients after coronary revascularization would be high [14,15]. However, MPI could stratify patients in low-to high-risk populations even if they had multivessel CAD, prior coronary revascularization.…”

Section: Discussionmentioning

confidence: 99%

Prognostic impact of reducing myocardial ischemia identified using ECG-gated myocardial perfusion SPECT in Japanese patients with coronary artery disease: J-ACCESS 4 study

Nanasato

Matsumoto

Nakajima

et al. 2018

International Journal of Cardiology

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“…Owing to the limited follow-up of 1 year, we were not able to observe potentially long-term adverse effects of reduced hospital admission in the chiropractic care group; however, we have previously shown that the risk of future cardiac events is low in patients with NSCP and will likely occur within the first year after hospitalisation, if at all. 44 …”

Section: Discussionmentioning

confidence: 99%

Cost-effectiveness of chiropractic care versus self-management in patients with musculoskeletal chest pain

et al. 2016

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AimsTo assess whether primary sector healthcare in the form of chiropractic care is cost-effective compared with self-management in patients with musculoskeletal chest pain, that is, a subgroup of patients with non-specific chest pain.Methods and results115 adults aged 18–75 years with acute, non-specific chest pain of musculoskeletal origin were recruited from a cardiology department in Denmark. After ruling out acute coronary syndrome and receiving usual care, patients with musculoskeletal chest pain were randomised to 4 weeks of community-based chiropractic care (n=59) or to a single information session aimed at encouraging self-management as complementary to usual care (n=56). Data on resource use were obtained from Danish national registries and valued from a societal perspective. Patient cost and health-related quality-adjusted life years (QALYs; based on EuroQol five-dimension questionnaire (EQ-5D) and Short Form 36-item Health Survey (SF-36)) were compared in cost-effectiveness analyses over 12 months from baseline. Mean costs were €2183 lower for the group with chiropractic care, but not statistically significant (95% CI −4410.5 to 43.0). The incremental cost-effectiveness ratio suggested that chiropractic care was cost-effective with a probability of 97%, given a threshold value of €30 000 per QALY gained. In both groups, there was an increase in the health-related quality of life, and the mean increases were similar over the 12-month evaluation period. The mean differences in QALYs between the groups were negligible.ConclusionsChiropractic care was more cost-effective than self-management. Therefore, chiropractic care can be seen as a good example of a targeted primary care approach for a subgroup of patients with non-specific chest pain.Trial registration numberNCT00462241.

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Clinical characteristics, myocardial perfusion deficits, and clinical outcomes of patients with non-specific chest pain hospitalized for suspected acute coronary syndrome: A 4-year prospective cohort study

Cited by 7 publications

References 35 publications

Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review

Major adverse cardiovascular event definitions used in observational analysis of administrative databases: a systematic review

Prognostic impact of reducing myocardial ischemia identified using ECG-gated myocardial perfusion SPECT in Japanese patients with coronary artery disease: J-ACCESS 4 study

Cost-effectiveness of chiropractic care versus self-management in patients with musculoskeletal chest pain

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