A037 Risk of Cardiac Events After Discharge From Hospital With Chest Pain and Whilst Awaiting Outpatient CT Coronary Angiography

Abstract

Chest pain patients, after exclusion of unstable angina, myocardial infarction and other significant conditions; and with the utlisation of risk scores (such as the mTIMI score); can be discharged from hospital, to reduce length of stay, but return for outpatient testing. We retrospectively audited, for adverse events, consecutive patients without prior diagnosis of coronary artery disease, who were discharged at physician discretion, to await outpatient CT coronary angiography (CTCA). The majority had assessment with an exercise treadmill test (ETT) before CTCA was requested. We identified 473 patients, 53% female (age 57.8±10.7 years), 47% male (age 55.2±11.1 years). Just over 50% had a waiting time to CTCA ≥ 30 days. Electronic patient records were reviewed. No patients had hard cardiac events (myocardial infarction, sudden cardiac death, or resuscitated cardiac arrest). Of the 429 patients with available data, 23 had soft events (readmission to hospital or contact from GP regarding concerning symptoms). Soft event rates were 5.1%, 4.8%, 7.3%, 3.3% in those with a mTIMI score of zero (n=196), one (n=124), two (n= 68), three or greater (n=30), respectively. Just over 75% had a mTIMI score of nil or one. No patient had a hard cardiovascular event. Soft events occurred in all mTIMI score groups. Further analysis of CTCA and ETT findings are underway to potentially assist better patient selection for CTCA after chest pain admission.