This single-center study suggests that deferring provocative testing to the outpatient setting is safe.
Debate continues regarding whether provocative testing is needed before emergency department (ED) discharge for low-risk chest pain patients. Investigators at a single academic ED in Vancouver, Canada, studied the 30-day rate of missed acute coronary syndrome or death in 1116 patients with chest pain who were discharged after 6 hours of observation if they did not have objective ischemia or ongoing pain.
Overall, 26% of patients were deemed very low risk and were discharged immediately without further investigation, 24% were referred for cardiology evaluation during their ED visit, 24% were referred for outpatient provocative testing after their ED visit, and the rest were discharged after ED observation and testing without recommendations f…
Reviewing Author
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals
DisclosuresConsultant/Advisory BoardPortola Pharmaceuticals, Inc.
Speaker’s BureauPeerView Institute for Medical Education
Grant/Research SupportAgency for Healthcare Research and Quality; CDC; NIH–National Center for Advancing Translational Sciences; NIH–National Institute of Allergy and Infectious Diseases (NIAID); NIH–NIAID–Antibacterial Resistance Leadership Group; Merck; Pfizer; Boehringer-Ingelheim; Shire; Portola Pharmaceuticals, Inc.; Novartis; bioMérieux; Siemens; Rapid Pathogen Screening; Magnolia; Stago; Innovative Biosensors; Molecular Detection, Inc.; Dyax Corp.; Trius Pharmaceuticals