CHA2DS2‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out
Background Chest‐pain patients deemed safe for discharge from internal medicine wards might still be at risk for adverse outcomes. Hypothesis CHA2DS2‐VASc score improves risk stratification of low‐risk chest‐pain patients discharged after acute coronary syndrome (ACS) rule‐out. Methods We accessed m...
Gespeichert in:
| Veröffentlicht in: | Clinical cardiology (Mahwah, N.J.) N.J.), 2018-04, Vol.41 (4), p.539-543 |
|---|---|
| Hauptverfasser: | , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 543 |
|---|---|
| container_issue | 4 |
| container_start_page | 539 |
| container_title | Clinical cardiology (Mahwah, N.J.) |
| container_volume | 41 |
| creator | Topaz, Guy Haisraely, Ory Shacham, Yacov Beery, Gil Shilo, Lotan Kassem, Nuha Pereg, David Kitay‐Cohen, Yona |
| description | Background
Chest‐pain patients deemed safe for discharge from internal medicine wards might still be at risk for adverse outcomes.
Hypothesis
CHA2DS2‐VASc score improves risk stratification of low‐risk chest‐pain patients discharged after acute coronary syndrome (ACS) rule‐out.
Methods
We accessed medical records of patients who were admitted to internal medicine wards at a single medical center during 2010–2016 and discharged following an ACS rule‐out. Patients were classified according to CHA2DS2‐VASc score: 0–1 (low), 2–3 (intermediate), >3 (high). Primary endpoint was occurrence of ACS at 1 year; 30‐day and 1‐year all‐cause mortality (ACM) were secondary outcomes.
Results
Of 12 449 patients, 7057 (57%) had low, 3781 (30%) intermediate, and 1611 (13%) high CHA2DS2‐VASc scores. Compared with a low score, intermediate and high scores were associated with significantly increased risk for 1‐year ACS during the first year (OR: 2.89, 95% CI: 1.91–4.37, P |
| doi_str_mv | 10.1002/clc.22925 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6489928</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2032539837</sourcerecordid><originalsourceid>FETCH-LOGICAL-p2285-256fb7e3f3b8b68b5cc315a4cbbe3491fa828ac3833fc892c18608385d840dbb3</originalsourceid><addsrcrecordid>eNpVUU1v1DAQtRCILoUD_8AS57SOvUnGF6RVoLTSShxKe7XsibPrymsvdsJqb_0J3Pl3_BLcD1XiNKOZN2_ezCPkY83Oasb4OXo841zy5hVZ1FLwCjrRvSYLVreskhzkCXmX812BMuDiLTnhsoWubdoF-dNfrviXa_73_vft6hppxpgs1WGg6F1wqD2N84RxZzONI93rydkwZXpw05bi1uap1Fygg8u41WljBzqmuKMuTDaFMr2zg0MXLD3oNGQ6Ru_jwYUN1ThPlpZ1Meh0pPkYhjJoaZq9LWrK1vfkzah9th-e4ym5ufj6o7-s1t-_XfWrdbXnHJqKN-1oOitGYcC0YBpEUTd6icZYsZT1qIGDRgFCjAiSYw0tAwHNAEs2GCNOyecn3v1silwsBybt1T65XVGmonbq_05wW7WJv1S7BFneWwg-PROk-HMuP1F3cX64PivOBG-EBNEV1PkT6uC8Pb7Q10w9mKiKierRRNWv-8dE_ANyXpWV</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2032539837</pqid></control><display><type>article</type><title>CHA2DS2‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out</title><source>Wiley Online Library Journals Frontfile Complete</source><source>EZB-FREE-00999 freely available EZB journals</source><source>PubMed Central</source><creator>Topaz, Guy ; Haisraely, Ory ; Shacham, Yacov ; Beery, Gil ; Shilo, Lotan ; Kassem, Nuha ; Pereg, David ; Kitay‐Cohen, Yona</creator><creatorcontrib>Topaz, Guy ; Haisraely, Ory ; Shacham, Yacov ; Beery, Gil ; Shilo, Lotan ; Kassem, Nuha ; Pereg, David ; Kitay‐Cohen, Yona</creatorcontrib><description>Background
Chest‐pain patients deemed safe for discharge from internal medicine wards might still be at risk for adverse outcomes.
Hypothesis
CHA2DS2‐VASc score improves risk stratification of low‐risk chest‐pain patients discharged after acute coronary syndrome (ACS) rule‐out.
Methods
We accessed medical records of patients who were admitted to internal medicine wards at a single medical center during 2010–2016 and discharged following an ACS rule‐out. Patients were classified according to CHA2DS2‐VASc score: 0–1 (low), 2–3 (intermediate), >3 (high). Primary endpoint was occurrence of ACS at 1 year; 30‐day and 1‐year all‐cause mortality (ACM) were secondary outcomes.
Results
Of 12 449 patients, 7057 (57%) had low, 3781 (30%) intermediate, and 1611 (13%) high CHA2DS2‐VASc scores. Compared with a low score, intermediate and high scores were associated with significantly increased risk for 1‐year ACS during the first year (OR: 2.89, 95% CI: 1.91–4.37, P < 0.01 and OR: 4.84, 95% CI: 3.02–7.74, P < 0.01, respectively). Each 1‐point increase in CHA2DS2‐VASc was associated with a 37% increased risk for 1‐year ACS. A higher CHA2DS2‐VASc score was associated with significantly higher 30‐day ACM. Hazard ratios for 30‐day ACM were 1.9 (95% CI: 1.1–3.4, P = 0.03) and 4.4 (95% CI: 2.4–7.9, P < 0.01) for intermediate and high CHA2DS2‐VASc scores, respectively, compared with a low score. Each 1‐point increase in CHA2DS2‐VASc score was associated with 43% increased risk for 30‐day mortality.
Conclusions
High CHA2DS2‐VASc score (>3) was associated with adverse outcomes among chest‐pain patients discharged from internal medicine wards following ACS rule‐out.</description><identifier>ISSN: 0160-9289</identifier><identifier>EISSN: 1932-8737</identifier><identifier>DOI: 10.1002/clc.22925</identifier><identifier>PMID: 29687656</identifier><language>eng</language><publisher>New York: Wiley Periodicals, Inc</publisher><subject>Acute Coronary Syndrome (ACS) ; Acute coronary syndromes ; CHA2DS2‐VASc Score ; Chest Pain ; Clinical Investigations ; Clinical outcomes ; Internal medicine ; Medicine ; Pain</subject><ispartof>Clinical cardiology (Mahwah, N.J.), 2018-04, Vol.41 (4), p.539-543</ispartof><rights>2018 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0002-7989-5817 ; 0000-0003-0805-3185 ; 0000-0002-5627-9712</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489928/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6489928/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,1411,27901,27902,45550,45551,53766,53768</link.rule.ids></links><search><creatorcontrib>Topaz, Guy</creatorcontrib><creatorcontrib>Haisraely, Ory</creatorcontrib><creatorcontrib>Shacham, Yacov</creatorcontrib><creatorcontrib>Beery, Gil</creatorcontrib><creatorcontrib>Shilo, Lotan</creatorcontrib><creatorcontrib>Kassem, Nuha</creatorcontrib><creatorcontrib>Pereg, David</creatorcontrib><creatorcontrib>Kitay‐Cohen, Yona</creatorcontrib><title>CHA2DS2‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out</title><title>Clinical cardiology (Mahwah, N.J.)</title><description>Background
Chest‐pain patients deemed safe for discharge from internal medicine wards might still be at risk for adverse outcomes.
Hypothesis
CHA2DS2‐VASc score improves risk stratification of low‐risk chest‐pain patients discharged after acute coronary syndrome (ACS) rule‐out.
Methods
We accessed medical records of patients who were admitted to internal medicine wards at a single medical center during 2010–2016 and discharged following an ACS rule‐out. Patients were classified according to CHA2DS2‐VASc score: 0–1 (low), 2–3 (intermediate), >3 (high). Primary endpoint was occurrence of ACS at 1 year; 30‐day and 1‐year all‐cause mortality (ACM) were secondary outcomes.
Results
Of 12 449 patients, 7057 (57%) had low, 3781 (30%) intermediate, and 1611 (13%) high CHA2DS2‐VASc scores. Compared with a low score, intermediate and high scores were associated with significantly increased risk for 1‐year ACS during the first year (OR: 2.89, 95% CI: 1.91–4.37, P < 0.01 and OR: 4.84, 95% CI: 3.02–7.74, P < 0.01, respectively). Each 1‐point increase in CHA2DS2‐VASc was associated with a 37% increased risk for 1‐year ACS. A higher CHA2DS2‐VASc score was associated with significantly higher 30‐day ACM. Hazard ratios for 30‐day ACM were 1.9 (95% CI: 1.1–3.4, P = 0.03) and 4.4 (95% CI: 2.4–7.9, P < 0.01) for intermediate and high CHA2DS2‐VASc scores, respectively, compared with a low score. Each 1‐point increase in CHA2DS2‐VASc score was associated with 43% increased risk for 30‐day mortality.
Conclusions
High CHA2DS2‐VASc score (>3) was associated with adverse outcomes among chest‐pain patients discharged from internal medicine wards following ACS rule‐out.</description><subject>Acute Coronary Syndrome (ACS)</subject><subject>Acute coronary syndromes</subject><subject>CHA2DS2‐VASc Score</subject><subject>Chest Pain</subject><subject>Clinical Investigations</subject><subject>Clinical outcomes</subject><subject>Internal medicine</subject><subject>Medicine</subject><subject>Pain</subject><issn>0160-9289</issn><issn>1932-8737</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNpVUU1v1DAQtRCILoUD_8AS57SOvUnGF6RVoLTSShxKe7XsibPrymsvdsJqb_0J3Pl3_BLcD1XiNKOZN2_ezCPkY83Oasb4OXo841zy5hVZ1FLwCjrRvSYLVreskhzkCXmX812BMuDiLTnhsoWubdoF-dNfrviXa_73_vft6hppxpgs1WGg6F1wqD2N84RxZzONI93rydkwZXpw05bi1uap1Fygg8u41WljBzqmuKMuTDaFMr2zg0MXLD3oNGQ6Ru_jwYUN1ThPlpZ1Meh0pPkYhjJoaZq9LWrK1vfkzah9th-e4ym5ufj6o7-s1t-_XfWrdbXnHJqKN-1oOitGYcC0YBpEUTd6icZYsZT1qIGDRgFCjAiSYw0tAwHNAEs2GCNOyecn3v1silwsBybt1T65XVGmonbq_05wW7WJv1S7BFneWwg-PROk-HMuP1F3cX64PivOBG-EBNEV1PkT6uC8Pb7Q10w9mKiKierRRNWv-8dE_ANyXpWV</recordid><startdate>201804</startdate><enddate>201804</enddate><creator>Topaz, Guy</creator><creator>Haisraely, Ory</creator><creator>Shacham, Yacov</creator><creator>Beery, Gil</creator><creator>Shilo, Lotan</creator><creator>Kassem, Nuha</creator><creator>Pereg, David</creator><creator>Kitay‐Cohen, Yona</creator><general>Wiley Periodicals, Inc</general><general>John Wiley & Sons, Inc</general><scope>K9.</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7989-5817</orcidid><orcidid>https://orcid.org/0000-0003-0805-3185</orcidid><orcidid>https://orcid.org/0000-0002-5627-9712</orcidid></search><sort><creationdate>201804</creationdate><title>CHA2DS2‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out</title><author>Topaz, Guy ; Haisraely, Ory ; Shacham, Yacov ; Beery, Gil ; Shilo, Lotan ; Kassem, Nuha ; Pereg, David ; Kitay‐Cohen, Yona</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p2285-256fb7e3f3b8b68b5cc315a4cbbe3491fa828ac3833fc892c18608385d840dbb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Acute Coronary Syndrome (ACS)</topic><topic>Acute coronary syndromes</topic><topic>CHA2DS2‐VASc Score</topic><topic>Chest Pain</topic><topic>Clinical Investigations</topic><topic>Clinical outcomes</topic><topic>Internal medicine</topic><topic>Medicine</topic><topic>Pain</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Topaz, Guy</creatorcontrib><creatorcontrib>Haisraely, Ory</creatorcontrib><creatorcontrib>Shacham, Yacov</creatorcontrib><creatorcontrib>Beery, Gil</creatorcontrib><creatorcontrib>Shilo, Lotan</creatorcontrib><creatorcontrib>Kassem, Nuha</creatorcontrib><creatorcontrib>Pereg, David</creatorcontrib><creatorcontrib>Kitay‐Cohen, Yona</creatorcontrib><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Topaz, Guy</au><au>Haisraely, Ory</au><au>Shacham, Yacov</au><au>Beery, Gil</au><au>Shilo, Lotan</au><au>Kassem, Nuha</au><au>Pereg, David</au><au>Kitay‐Cohen, Yona</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>CHA2DS2‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out</atitle><jtitle>Clinical cardiology (Mahwah, N.J.)</jtitle><date>2018-04</date><risdate>2018</risdate><volume>41</volume><issue>4</issue><spage>539</spage><epage>543</epage><pages>539-543</pages><issn>0160-9289</issn><eissn>1932-8737</eissn><abstract>Background
Chest‐pain patients deemed safe for discharge from internal medicine wards might still be at risk for adverse outcomes.
Hypothesis
CHA2DS2‐VASc score improves risk stratification of low‐risk chest‐pain patients discharged after acute coronary syndrome (ACS) rule‐out.
Methods
We accessed medical records of patients who were admitted to internal medicine wards at a single medical center during 2010–2016 and discharged following an ACS rule‐out. Patients were classified according to CHA2DS2‐VASc score: 0–1 (low), 2–3 (intermediate), >3 (high). Primary endpoint was occurrence of ACS at 1 year; 30‐day and 1‐year all‐cause mortality (ACM) were secondary outcomes.
Results
Of 12 449 patients, 7057 (57%) had low, 3781 (30%) intermediate, and 1611 (13%) high CHA2DS2‐VASc scores. Compared with a low score, intermediate and high scores were associated with significantly increased risk for 1‐year ACS during the first year (OR: 2.89, 95% CI: 1.91–4.37, P < 0.01 and OR: 4.84, 95% CI: 3.02–7.74, P < 0.01, respectively). Each 1‐point increase in CHA2DS2‐VASc was associated with a 37% increased risk for 1‐year ACS. A higher CHA2DS2‐VASc score was associated with significantly higher 30‐day ACM. Hazard ratios for 30‐day ACM were 1.9 (95% CI: 1.1–3.4, P = 0.03) and 4.4 (95% CI: 2.4–7.9, P < 0.01) for intermediate and high CHA2DS2‐VASc scores, respectively, compared with a low score. Each 1‐point increase in CHA2DS2‐VASc score was associated with 43% increased risk for 30‐day mortality.
Conclusions
High CHA2DS2‐VASc score (>3) was associated with adverse outcomes among chest‐pain patients discharged from internal medicine wards following ACS rule‐out.</abstract><cop>New York</cop><pub>Wiley Periodicals, Inc</pub><pmid>29687656</pmid><doi>10.1002/clc.22925</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-7989-5817</orcidid><orcidid>https://orcid.org/0000-0003-0805-3185</orcidid><orcidid>https://orcid.org/0000-0002-5627-9712</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0160-9289 |
| ispartof | Clinical cardiology (Mahwah, N.J.), 2018-04, Vol.41 (4), p.539-543 |
| issn | 0160-9289 1932-8737 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6489928 |
| source | Wiley Online Library Journals Frontfile Complete; EZB-FREE-00999 freely available EZB journals; PubMed Central |
| subjects | Acute Coronary Syndrome (ACS) Acute coronary syndromes CHA2DS2‐VASc Score Chest Pain Clinical Investigations Clinical outcomes Internal medicine Medicine Pain |
| title | CHA2DS2‐VASc score and clinical outcomes of patients with chest pain discharged from internal medicine wards following acute coronary syndrome rule‐out |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-04T06%3A55%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=CHA2DS2%E2%80%90VASc%20score%20and%20clinical%20outcomes%20of%20patients%20with%20chest%20pain%20discharged%20from%20internal%20medicine%20wards%20following%20acute%20coronary%20syndrome%20rule%E2%80%90out&rft.jtitle=Clinical%20cardiology%20(Mahwah,%20N.J.)&rft.au=Topaz,%20Guy&rft.date=2018-04&rft.volume=41&rft.issue=4&rft.spage=539&rft.epage=543&rft.pages=539-543&rft.issn=0160-9289&rft.eissn=1932-8737&rft_id=info:doi/10.1002/clc.22925&rft_dat=%3Cproquest_pubme%3E2032539837%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2032539837&rft_id=info:pmid/29687656&rfr_iscdi=true |