Prevalence and prognosis of non-specific chest pain among patients hospitalized for suspected acute coronary syndrome - a systematic literature search Full Text
BMC Medicine, 06/13/2012
Ruddox V et al. - Patients with non-specific chest pain (NSCP) represent a large, heterogeneous and important group. Due to co-existing coronary heart disease (CHD) in nearly 40% of these patients, their prognosis is not necessarily benign. Although their average one-year mortality rate was almost 6 times lower than those with "ACS/high-risk", the subset with concomitant CHD had a relatively poor prognosis when compared with NSCP patients without evidence of CHD.
Methods- This is a systematic literature search where 3 databases were searched from 1990 onwards to 14 NOV 2011. In addition, one database was searched for Epub ahead of print per 24 MAR 2012.
- Three inclusion criteria were applied: 1. Documentation of an unselected consecutive series of patients admitted for chest pain, where this review is based upon two groups of patients defined as follows: a) "ACS/high-risk" and b) NSCP. 2. At least 100 cases with NSCP. 3. Follow-up of hospital readmissions and mortality for at least 6 months.
- A total of 2204 citations were screened after removal of duplicates.
- Out of 80 full text articles assessed for eligibility 12 studies were included, comprising 24829 patients (inter-study range 250 - 13762), with 11008 (44%) categorized as NSCP and 13821 (56%) as "ACS/high-risk".
- The mean one-year total mortality rate among patients with NSCP in 9 studies was 3.2% (inter-study range 1.4 - 8.1%), with the highest mortality among patients with pre-existing coronary heart disease (CHD).
- The mean one-year mortality rate among "ACS/high-risk" patients was 18.0% (inter-study range 14.0 - 19.9%) in 4 studies with available data.
- In 6 studies the mean one-year readmission rate for patients with NSCP was 17.5% (inter-study range 2.5% - 40%).
