Background: Chest pain (CP) is a common presenting symptom in Emergency Rooms (ER). As part of the Israeli multicenter 2DSPER study, we analyzed baseline characteristics of patients presenting to ERs with CP, with and without acute coronary syndromes (ACS).
Methods: We prospectively enrolled patients from 11 Israeli hospitals, who presented to the ER with CP but without diagnostic ECG changes or troponin elevations. Data was collected prospectively about patients` background, coronary risk factors, symptoms and basic lab results. Following a comprehensive evaluation, those with ACS were identified.
Results: Full data on 606 patients was available for analysis, 74 of them were subsequently diagnosed as ACS. The average patient was 58.1±8.7 y.o. and 70.4% were males. Body mass index (BMI) was 28.2±4.7kg/m2, prevalence of risk factors was: hyperlipidemia- 54.6%, hypertension- 47.2%, family history of ischemic heart disease (f/h IHD)- 35%, smokers- 34% and 25% had diabetes. Mean CP duration was 2.4±5.0 hours and during 24 hrs prior to admission they had 3.1±3.4 episodes of CP. Compared to non-ACS patients, those with ACS were more often males (91 vs. 68%, p<0.0001), had a higher prevalence of diabetes (43 vs. 23%, p<0.0001), hypertension (59 vs. 45%, p<0.03), hyperlipidemia (69 vs. 53%, p<0.01), as were levels of creatinine (0.93 vs. 0.85 mg%, p<0.002) and hemoglobin (16±14 vs. 14±1.5 g%, p<0.006).
Conclusions: Characteristics of patients presenting to the ED with CP but without evidence of ACS are described. Although patients with ACS had a higher prevalence of coronary risk factors, they were also relatively prevalent in those without ACS, potentially affecting the accuracy of LS analysis.
