Kogan Asia, Shapira Reuma, Lewis Basil S, Tamir Ada, Rennert Gad
Emergency Department, Carmel Medical Center, Haifa 34362, Israel.
Am J Emerg Med. 2009 Sep;27(7):889-92. doi: 10.1016/j.ajem.2008.06.009.
This retrospective study assessed the contribution of exercise stress testing (EST) in the evaluation of patients with low risk for coronary heart disease who presented to the emergency department (ED) with chest pain.
The study included 175 patients who presented to the ED with chest pain and underwent EST between January 1, 2005, and November 30, 2006.
After the EST, 113 patients were discharged, and 62 were admitted. Exercise stress testing's positive predictive value for coronary artery disease among admitted patients was 35.7%, and sensitivity was 95.2%. Exercise stress testing's negative predictive value among discharged patients was 99.1%. None of the 113 discharged patients returned to the ED for cardiac reasons during the 30-day follow-up period.
A chest pain unit or a parallel facility for evaluating patients with chest pain and with low risk for active coronary disease is necessary for detecting low-risk patients who eventually need cardiac intervention.
本回顾性研究评估了运动负荷试验（EST）在评估因胸痛就诊于急诊科（ED）的冠心病低风险患者中的作用。
该研究纳入了2005年1月1日至2006年11月30日期间因胸痛就诊于急诊科并接受EST的175例患者。
EST后，113例患者出院，62例患者入院。入院患者中EST对冠心病的阳性预测值为35.7%，敏感性为95.2%。出院患者中EST的阴性预测值为99.1%。在30天随访期内，113例出院患者中无一因心脏原因返回急诊科。
胸痛单元或用于评估胸痛且活动性冠心病风险低的患者的并行设施对于检测最终需要心脏干预的低风险患者是必要的。
