Hypertension predicts major adverse cardiac events after discharge from the emergency department with unspecified chest pain

European Heart Journal. Acute Cardiovascular Care
Åsa OmstedtPer Svensson

Abstract

To investigate the incidence of major adverse cardiac events (MACEs) after discharge from the emergency department (ED) with unspecified chest pain and the predictive value of cardiovascular risk factors included in HEART score. This was a register-based retrospective cohort study including all patients discharged with the diagnosis 'unspecified chest pain' from Swedish EDs between 2006-2013. Diagnosis and drug prescriptions were collected from national registers and the association to the occurrence of MACE was studied with logistic regression and category-free net reclassification improvement (cNRI). Out of 74,329 included patients 619 (0.8%) experienced MACE within 30 days of discharge from the ED. Hypertension (odds ratio (OR) 4.74, 95% confidence interval (CI) 4.02-5.59), diabetes mellitus (3.76, 3.10-4.57), hyperlipidaemia (1.92, 1.51-2.44), and earlier cardiovascular disease (CVD) were all associated with MACE. The addition of hypertension to a risk factor model improved net reclassification (cNRI 53%, 95% CI 29-67%). The variables age (A) (1 point OR 7.01, 95% CI 4.79-10.26, 2 points OR 23.57, 95% CI 16.35-33.97) and risk factors (R) (1 point OR 3.76, 95% CI 3.05-4.63, 2 points OR 10.94, 95% CI 8.96-13.38) in HEART scor...Continue Reading

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Citations

May 23, 2016·Current Hypertension Reports·Per H Skoglund, Per Svensson
Feb 13, 2018·Critical Pathways in Cardiology·Anna PetterssonPer Svensson
Jan 6, 2017·BMC Cardiovascular Disorders·I-Ting TsaiTeng-Hung Yu
Oct 26, 2018·Arteriosclerosis, Thrombosis, and Vascular Biology·Yuen-Kwun WongHung-Fat Tse
May 28, 2019·European Heart Journal. Acute Cardiovascular Care·Agnes WahrenbergPer Svensson
Feb 13, 2021·Journal of Internal Medicine·B LindahlUNKNOWN DETO2X-SWEDEHEART Investigators

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Methods Mentioned

BETA
coronary artery bypass

Software Mentioned

SPSS Statistics
StataCorp Stata

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