Chest pain can be a sign of heart health problems. But it is often hard to tell accurately.
Recently, researchers have invented a new tool to solve the problem.
In a two-year study involving more than 10,000 people with stable chest pain, the researchers find that an online tool can accurately predict which patients are likely to have normal non-invasive tests and remain free of cardiac events.
The finding could lead to better decision making in primary care doctors because they will be able to identify patients at minimal risk for heart issues.
The study is published in JAMA Cardiology.
In the study, the team analyzed data from a 2015 clinical trial. Over 10,000 patients at 193 sites in North America were enrolled.
These people had no known coronary artery disease, or coronary heart disease, but who reported chest pain or equivalent symptoms to their doctors.
They were referred for non-invasive testing to assess for heart disease. They took either an exercise stress test (often with an imaging study of heart blood flow or function) or a CT scan of the coronary arteries.
The researchers found that both tests to be equally accurate in detecting heart trouble, but about 25% of patients had completely normal results.
To predict heart disease risk better, the team developed a web-based, risk prediction tool using 10 clinical variables that are commonly available to a physician during an evaluation.
The 10 variables are: younger age; female sex; racial or ethnic minority; no history of hypertension, diabetes, dyslipidemia or family history of premature coronary artery disease; never smoking; symptoms unrelated to physical exertion or stress; and higher high-density lipoprotein (HDL) cholesterol.
The tool can be found at http://www.promiserisktools.com.
Interestingly, in another recent study, researchers from Mayo Clinic also developed a tool to determine if a chest pain is dangerous or not.
According to the research team, this tool only uses 1 minute to make the decision.
The tool is called Chest Pain Choice, and it uses a shared decision-making aid to involve patients more in their own care decisions.
It can help patients with low-risk chest pain estimate the risk for acute coronary syndrome within the next 45 days.
Based on the risk shown by the tool, patients can then have a joint discussion with their doctors on whether hospital admission and advanced cardiac testing is warranted, or whether a follow-up appointment with primary care or cardiology is a more appropriate step.
The study shows that such a tool can help improve patients’ knowledge, involve patients more into the decision-making part, and reduce unnecessary hospital admissions.
Both patients and doctors are satisfied with the decision aid and its use, because the tool takes an average of one additional minute of clinician time.
The researchers said that this tool can reduce the overall burden on the health care system as well as potential costs for patients.
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