AI Article Synopsis

  • The study aimed to compare coronary artery calcification (CAC) prevalence and cardiac events between patients with non-specific chest pain (NSCP) and a general population.
  • It used a double-blinded, observational approach with CT scans to measure CAC and tracked cardiac events over one year.
  • Results showed no significant difference in CAC prevalence or cardiac events between NSCP patients and the background population, indicating limited clinical value for CAC studies in NSCP risk assessment.

Article Abstract

Objectives: To examine and compare the prevalence of coronary artery calcification (CAC) and the frequency of cardiac events in a background population and a cohort of patients with non-specific chest pain (NSCP) who present to an emergency or cardiology department and are discharged without an obvious reason for their symptom.

Design: A double-blinded, prospective, observational cohort study that measures both CT-determined CAC scores and cardiac events after 1 year of follow-up.

Setting: Emergency and cardiology departments in the Region of Southern Denmark.

Subjects: In total, 229 patients with NSCP were compared with 722 patients from a background comparator population.

Main Outcomes Measures: Prevalence of CAC and incidence of unstable angina (UAP), acute myocardial infarction (MI), ventricular tachycardia (VT), coronary revascularisation and cardiac-related mortality 1 year after index contact.

Results: There was no significant difference in the prevalence of CAC (OR 0.9 (95% CI 0.6 to 1.3), P=0.546) or the frequency of cardiac endpoints (P=0.64) between the studied groups. When compared with the background population, the OR for patients with NSCP for a CAC >100 Agatston units (AU) was 1.0 (95% CI 0.6 to 1.5), P=0.826. During 1 year of follow-up, two (0.9%) patients with NSCP underwent cardiac revascularisation, while none experienced UAP, MI, VT or death. In the background population, four (0.6%) participants experienced a clinical cardiac endpoint; two had an MI, one had VT and one had a cardiac-related death.

Conclusion: The prevalence of CAC (CAC >0 AU) among patients with NSCP is comparable to a background population and there is a low risk of a cardiac event in the first year after discharge. A CAC study does not provide notable clinical utility for risk-stratifying patients with NSCP.

Trial Registration Number: NCT02422316; Pre-results.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5855253PMC
http://dx.doi.org/10.1136/bmjopen-2017-018391DOI Listing

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