Prediction of missed myocardial infarction among symptomatic outpatients without coronary heart disease

Sequist, Thomas D.; Bates, David W.; Cook, E. Francis; Lampert, Steven; Schaefer, Mary M.; Wright, Jenny; Sato, Luke; Lee, Thomas H.

doi:10.1016/j.ahj.2004.06.014

Cited by 19 publications

(25 citation statements)

References 15 publications

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“…MS users had significantly higher levels of TG, but lower levels of LDL and HDL ( table 4 ). Since low HDL has been known to be a risk factor for cardiac diseases [34] , and increases in lipid levels, except HDL, mean increased risk for many systemic diseases [35] , the AA user group in the present study appears to have the worst serum glucose and lipid profi le among the groups.…”

Section: Discussionmentioning

confidence: 67%

Atypical Antipsychotic Usage-Related Higher Serum Leptin Levels and Disabled Lipid Profiles in Euthymic Bipolar Patients

Gergerlioğlu¹,

Savaş²,

Çelik

et al. 2006

Neuropsychobiology

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Atypical antipsychotics (AA)-induced weight gain is associated with increased leptin levels. AA have been increasingly used in the treatment of bipolar disorders. This cross-sectional study aimed to evaluate the association between serum leptin and lipid profiles considering the drug treatments in euthymic bipolar outpatients. Leptin and lipid profiles were compared, and no differences were noted in leptin, cholesterol, and low-density lipoprotein levels among the patients and controls. Glucose, very-low-density lipoprotein, and triglyceride levels in patients were higher than in controls, while high-density lipoprotein levels were low. Patients were divided into three groups according to their type of drug usage: AA users, AA + mood stabilizer users, and mood stabilizer users. Each group of patients was compared with a healthy control group for mentioned biochemical parameters. Lipid profiles were disordered by using both AA and mood stabilizers, but higher leptin levels are associated with AA usage. However, leptin does not seem to be responsible for dyslipidemia caused by AA or mood stabilizers in euthymic bipolar patients.

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Section: Discussionmentioning

confidence: 67%

Atypical Antipsychotic Usage-Related Higher Serum Leptin Levels and Disabled Lipid Profiles in Euthymic Bipolar Patients

Gergerlioğlu¹,

Savaş²,

Çelik

et al. 2006

Neuropsychobiology

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“…The rapid pace and short duration of observation may make patients in EDs particularly vulnerable to diagnostic error. Missed diagnoses in the ED often result in additional acute care services along with repeated testing, delays in appropriate treatment, increased mortality [32,33], and more dollars recovered in malpractice suits than any other medical error [34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Missed diagnoses of acute myocardial infarction in the emergency department: variation by patient and facility characteristics

et al. 2014

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Background: An estimated 1.2 million people in the US have an acute myocardial infarction (AMI) each year. An estimated 7% of AMI hospitalizations result in death. Most patients experiencing acute coronary symptoms, such as unstable angina, visit an emergency department (ED). Some patients hospitalized with AMI after a treatand-release ED visit likely represent missed opportunities for correct diagnosis and treatment. The purpose of the present study is to estimate the frequency of missed AMI or its precursors in the ED by examining use of EDs prior to hospitalization for AMI. Methods: We estimated the rate of probable missed diagnoses in EDs in the week before hospitalization for AMI and examined associated factors. We used Healthcare Cost and Utilization Project State Inpatient Databases and State Emergency Department Databases for 2007 to evaluate missed diagnoses in 111,973 admitted patients aged 18 years and older. Results: We identified missed diagnoses in the ED for 993 of 112,000 patients (0.9% of all AMI admissions). These patients had visited an ED with chest pain or cardiac conditions, were released, and were subsequently admitted for AMI within 7 days. Higher odds of having missed diagnoses were associated with being younger and of Black

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“…1,2 This challenge is highlighted in the primary care office, where one-quarter of all chest pain evaluations take place, 3 and where important gaps in the quality and safety of chest pain evaluations exist. 4,5 There is an extensive literature to guide the evaluation of chest pain in the emergency department; 1,2 however, the optimal primary care approach may be fundamentally different. Primary care offices have limited capability to perform serial cardiac enzymes or immediate exercise stress testing as is done in the emergency department, 6 and the patients are relatively low risk for cardiovascular disease.…”

Section: Introductionmentioning

confidence: 99%

“…7 The relative infrequency of serious diagnoses, combined with time pressures and fear of litigation may lead to a combination of performing many unnecessary cardiac stress tests for low risk patients, 8 and a high potential to miss the diagnosis of the uncommon acute myocardial infarction. Indeed, the majority of primary care patients with chest pain do not have an electrocardiogram performed or receive aspirin therapy, 4,5 despite their key role in the evaluation and management of this condition. [9][10][11] Ultimately, missed diagnosis of myocardial infarction in primary care is common.…”

Section: Introductionmentioning

confidence: 99%

“…12 Providing clinicians with real-time information to promote risk-appropriate clinical decisions may increase the accuracy and efficiency of chest pain care, 13,14 and the Framingham Risk Score represents a reliable tool to risk stratify patients with chest pain in primary care. 4,5 We conducted a randomized, controlled trial to assess the impact of delivering real-time cardiac risk information within an electronic health record to primary care clinicians evaluating patients complaining of chest pain.…”

Section: Introductionmentioning

confidence: 99%

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Electronic Risk Alerts to Improve Primary Care Management of Chest Pain: A Randomized, Controlled Trial

et al. 2011

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Prediction of missed myocardial infarction among symptomatic outpatients without coronary heart disease

Cited by 19 publications

References 15 publications

Atypical Antipsychotic Usage-Related Higher Serum Leptin Levels and Disabled Lipid Profiles in Euthymic Bipolar Patients

Atypical Antipsychotic Usage-Related Higher Serum Leptin Levels and Disabled Lipid Profiles in Euthymic Bipolar Patients

Missed diagnoses of acute myocardial infarction in the emergency department: variation by patient and facility characteristics

Electronic Risk Alerts to Improve Primary Care Management of Chest Pain: A Randomized, Controlled Trial

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