Risk stratification in chest pain patients undergoing nuclear stress testing

The erlanger stress score

Francis M. Fesmire, Ron C. Buchheit, Yu Cao, Harry W. Severance, Yi Jang, Gregory Heath

Research output: Contribution to journalArticle

Abstract

BACKGROUND:: Studies have individually reported the relationship of age, cardiac risk factors, and history of preexisting coronary artery disease (CAD) for predicting acute coronary syndromes in chest pain patients undergoing cardiac stress testing. In this study, we investigate the interplay of all these factors on the incidence of acute coronary syndromes to develop a tool that may assist physicians in the selection of appropriate chest pain patients for stress testing. METHODS:: Retrospective analysis of a prospectively acquired database of consecutive chest pain patients undergoing nuclear stress testing. Backward stepwise logistic regression was used to develop a model for predicting risk of 30-day acute coronary events (ACE) using information obtained from age, sex, cardiac risk factors, and history of preexisting CAD. RESULTS:: A total of 800 chest pain patients underwent nuclear stress testing. ACE occurred in 74 patients (9.3%). Logistic regression analysis found only 6 factors predictive of ACE: age, male sex, preexisting CAD, diabetes, and hyperlipidemia. Area under the receiver operator characteristic curve of this model for predicting ACE was 0.767 (95% confidence interval, 0.719-0.815). There were no cases of ACE in the 173 patients with predicted probability estimates ≤2.5% (95% confidence interval, 0%-2.1%). CONCLUSIONS:: A regression model using age, sex, preexisting CAD, diabetes, and hyperlipidemia is predictive of 30-day ACE in chest pain patients undergoing nuclear stress testing. Prospective studies need to be performed to determine whether this model can assist physicians in the selection of appropriate low-to-intermediate risk chest pain patients for nuclear stress testing.

Original languageEnglish (US)
Pages (from-to)171-176
Number of pages6
JournalCritical Pathways in Cardiology
Volume11
Issue number4
DOIs
StatePublished - Dec 1 2012
Externally publishedYes

Fingerprint

Chest Pain
Coronary Artery Disease
Acute Coronary Syndrome
Hyperlipidemias
Logistic Models
Confidence Intervals
Physicians
Regression Analysis
Databases
Prospective Studies
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Risk stratification in chest pain patients undergoing nuclear stress testing : The erlanger stress score. / Fesmire, Francis M.; Buchheit, Ron C.; Cao, Yu; Severance, Harry W.; Jang, Yi; Heath, Gregory.

In: Critical Pathways in Cardiology, Vol. 11, No. 4, 01.12.2012, p. 171-176.

Research output: Contribution to journalArticle

Fesmire, Francis M. ; Buchheit, Ron C. ; Cao, Yu ; Severance, Harry W. ; Jang, Yi ; Heath, Gregory. / Risk stratification in chest pain patients undergoing nuclear stress testing : The erlanger stress score. In: Critical Pathways in Cardiology. 2012 ; Vol. 11, No. 4. pp. 171-176.
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