Physical fitness cannot be used to predict the likelihood of acute coronary syndromes in ED patients with chest pain
| Autor: | Jasmine Chohan, Regina M. Troxell, Daniel Dickinson, Breena R. Taira, Taku Taira, Henry C. Thode, Adam J. Singer |
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| Rok vydání: | 2010 |
| Předmět: |
Male
Acute coronary syndrome medicine.medical_specialty Chest Pain Physical fitness Chest pain Culprit Electrocardiography Risk Factors Internal medicine medicine Odds Ratio Humans Prospective Studies Acute Coronary Syndrome Chi-Square Distribution business.industry Troponin I General Medicine Odds ratio Emergency department Middle Aged medicine.disease Confidence interval Surgery Logistic Models Echocardiography Physical Fitness Cohort Multivariate Analysis Emergency Medicine Exercise Test Female medicine.symptom business Emergency Service Hospital |
| Zdroj: | The American journal of emergency medicine. 30(1) |
| ISSN: | 1532-8171 |
| Popis: | Objective The objective of the study was to explore the association between physical fitness and the likelihood of acute coronary syndrome (ACS) in patients presenting to the emergency department (ED) with chest pain (CP). We hypothesized that the likelihood of ACS would be lower in physically fit patients and higher in patients with exercise-induced CP. Methods The study involved a prospective, descriptive cohort in an academic suburban ED. Subjects were ED patients with CP admitted for suspected ACS. Demographic and clinical data were collected by trained research assistants using standardized forms. Patients were surveyed on level of fitness and whether they had ever experienced anginal type symptoms during exercise. Acute coronary syndrome was considered present if the patient had electrocardiographic evidence of infarction or ischemia; elevated troponin I levels; greater than 70% stenosis of culprit coronary artery; or a positive nuclear, echocardiographic, or treadmill stress test result. Patients readmitted within 30 days for reinfarction, cardiogenic shock, or arrhythmias were also considered to have ACS. The association between physical fitness and ACS was determined using χ2 tests and odds ratios (ORs). Results One hundred patients were enrolled. Mean age was 55.8 (±15.3) years; 36% were female; 85% were white. Thirteen (13%) patients had positive troponins, 22 of 36 catheterized patients had greater than 70% coronary artery stenosis, and 6 (6%) had abnormal stress test results. There were no deaths or reinfarctions within 30 days. The rate of ACS was similar in patients who were physically fit and those who were not (24% vs 37%; OR, 0.5 [95% confidence interval, 0.2-1.3]) and in patients who had experienced exercise-induced CP and those who had not (32% vs 29%; OR, 1.2 [95% confidence interval, 0.4-3.2]). Neither the frequency nor the intensity of exercise was associated with ACS. Conclusions Physically fit patients with CP were as likely to have ACS as those not physically fit. A history of exercise-induced CP was not associated with an increased likelihood of ACS. |
| Databáze: | OpenAIRE |
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