Association of accompanying dyspnoea with diagnosis and outcome of patients presenting with acute chest discomfort
Authors' conclusion
Accompanying dyspnoea was not associated with a higher prevalence of ACS but with cardiac, non-coronary disease. While the safety of the diagnostic work-up was not affected, accompanying dyspnoea was an independent predictor for cardiovascular and all-cause death.
Study context
- Population
- Patients presenting to the emergency department (ED) with acute chest pain/discomfort
- Participants
- 6,045 patients
- Exposure
- Accompanying dyspnoea vs no dyspnoea
- Dyspnoean = 2,892
- Outcome
- Final diagnosis (adjudicated by independent cardiologists)
Methodological detailsFinal diagnoses adjudicated by independent cardiologists using all information including cardiac imaging
- Final diagnoses adjudicated by independent cardiologists using all information including cardiac imaging
Main finding
As reported in the abstract
Final diagnosis
MI
P = 0.60
Unstable angina
P = 0.29
Cardiac, non-coronary disease
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| CV and all-cause death · 2 yearsIndependent predictor | 1.813 (1.453–2.261) | P < 0.01 | |
| 0.512Hazard ratio (log scale) |
Diagnostic performance of hs-cTnT/I and European Society of Cardiology (ESC) 0/1h-algorithms for myocardial infarction (MI)
- AUC of hs-cTnT/I in both groups (not affected by dyspnoea)
- 0.89-0.91
- NPV of ESC 0/1h-algorithms (safety maintained)
- >99.4%
Original publication
Association of accompanying dyspnoea with diagnosis and outcome of patients presenting with acute chest discomfort. Eur Heart J Acute Cardiovasc Care. Published 14 March 2023. doi:10.
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