Service de cardiologie, hôpital européen Georges-Pompidou, Assistance publique-Hôpitaux de Paris, université Paris-Descartes, 20, rue Leblanc, 75908 Paris cedex 15, France.
Arch Cardiovasc Dis. 2009 Dec;102(12):803-9. doi: 10.1016/j.acvd.2009.09.008. Epub 2009 Nov 5.
Chest pain units (CPUs) are very popular in the USA for the triage of low-to-intermediate-risk chest pains. However, CPUs do not yet exist in France.
To determine the prevalence and clinical characteristics of patients admitted to a new CPU in France, and to assess the quality of care with regard to identification and exclusion of an acute coronary syndromes (ACS).
This prospective study included 906 consecutive patients with non-traumatic chest pain admitted to our CPU between September 2006 and August 2008. Patients were managed according to their probability of presenting with an ACS. Clinical characteristics, diagnostic tests, final diagnosis, destination and length of stay were recorded. We also assessed the 30-day outcome of patients in whom an ACS was excluded.
Of the 906 patients, 27.9% had an ACS (1.3% with and 26.6% without ST-segment elevation, respectively). Non-ischaemic cardiac aetiologies and non-cardiac aetiologies were found in 123 (12.6%) and 63 (7.0%) patients, respectively. A final diagnosis of chest pain of undetermined origin was made in 51.5% of patients; among these, 17 (6.5%) patients were re-admitted to the CPU between September 2006 and September 2007. Thirty-day follow-up revealed that only one patient had subsequent confirmation of coronary artery disease requiring further hospitalization.
This prospective study reports the first experience of a CPU in a cardiology department in France. Our preliminary results suggest that our CPU can exclude an ACS safely. Further studies are warranted to assess the value of CPUs in France.
胸痛单元（CPU）在美国非常流行，用于低至中度风险胸痛的分诊。然而，法国目前还没有胸痛单元。
确定法国新胸痛单元收治患者的患病率和临床特征，并评估在识别和排除急性冠脉综合征（ACS）方面的护理质量。
这项前瞻性研究纳入了 2006 年 9 月至 2008 年 8 月期间因非创伤性胸痛收入我们胸痛单元的 906 例连续患者。根据患者出现 ACS 的可能性对其进行管理。记录患者的临床特征、诊断性检查、最终诊断、去向和住院时间。我们还评估了排除 ACS 后患者的 30 天转归。
906 例患者中，27.9%患有 ACS（分别有 1.3%和 26.6%患者存在 ST 段抬高）。123 例（12.6%）患者存在非缺血性心脏病因，63 例（7.0%）患者存在非心脏病因。51.5%的患者最终诊断为胸痛原因不明；其中 17 例（6.5%）患者于 2006 年 9 月至 2007 年 9 月期间再次收入胸痛单元。30 天随访显示，仅有 1 例患者随后确诊需要进一步住院治疗的冠状动脉疾病。
这项前瞻性研究报告了法国心内科胸痛单元的首次经验。我们的初步结果表明，我们的胸痛单元可以安全地排除 ACS。需要进一步的研究来评估法国胸痛单元的价值。
