To assess the prognosis of patients having chest pain without final diagnosis at the term of CPU evaluation.
Between January 2010 and December 2012, 1374 patients were admitted for non-traumatic chest pain in Angers Hospital CPU and analysed retrospectively. Clinical characteristics, final diagnosis and functional tests performed were noted. Primary outcome was major cardiac events (cardiovascular death or STEMI) occurring during the first year of follow-up. MACCEs, chest pain recurrence and rehospitalizations during long-term follow-up were analysed as secondary endpoints.
250 patients (18.2%) displayed an acute coronary syndrome and 678 (49.3%) had chest pain without final established diagnosis. Among them, only 1 patient displays a major cardiac event (cardiovascular death) < 1 year after CPU discharge. 11 cardiovascular deaths (1.8%) and 37 MACCEs (5.9%) were numbered during follow-up (median time=3.6 years [2.79; 4.25]). Recurrent chest pain was frequent (34.3%) but was not predictive of MACCEs.
CPU evaluation is safe to rule out correctly acute coronary syndrome and patients presenting a negative evaluation display a low rate of major cardiac events. Further prospective studies are needed to support these preliminary results.
The author hereby declares no conflict of interest