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      Rate of Admission and Long-Term Prognosis among Patients with Acute Chest Pain in the 1990s Compared with the 1980s

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          We describe the incidence of acute chest pain (requiring admission to the emergency department) and the prognosis during two time periods in all patients admitted to the emergency department at Sahlgrenska University Hospital in Göteborg, Sweden, with acute chest pain 1986 and 1987 (period 1) and 1996 and 1997 (period 2). The rate of admission for chest pain/100,000 inhabitants was 4.7/day during period 1 and 5.0/day during period 2. The risk ratio for death adjusted for eight risk factors during period 2 in relation to period 1 was 0.88 (95% CI 0.79–0.97). There was a significant interaction between time period and the severity of the final diagnosis (p = 0.02), indicating a greater reduction in mortality among patients with acute myocardial infarction.

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          Most cited references 7

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          Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S)

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            Patients admitted to the emergency room with symptoms indicative of acute myocardial infarction.

            All 7157 patients (55% men) admitted to the emergency room with chest pain or other symptoms indicative of acute myocardial infarction during a period of 21 months were registered consecutively. Chest pain was reported by 93% of the patients. On the basis of history, clinical examination, and electrocardiogram in the emergency room, all patients were prospectively classified in one of four categories: (i) obvious infarction (4% of all patients); (ii) strongly suspected infarction (20%); (iii) vague suspicion of infarction (35%); and (iv) no suspected infarction (41%). In patients with no suspected infarction (n = 2910), musculoskeletal (26%), obscure (21%) and psychogenic origins (16%) of the symptoms occurred most frequently. We conclude that few of the patients had an obvious infarction on admission, and that a musculoskeletal origin of the symptoms occurred most frequently in patients with no suspected infarction.
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              Prognosis after acute myocardial infarction continues to improve in the reperfusion era in the community of Göteborg.

              The objective of this study was to compare the prognosis of nonselected patients who had an acute myocardial infarction (AMI) during 2 time periods in the thrombolytic era and to describe coronary heart disease (CHD) mortality rates in the community of Göteborg during 1990 to 1995.

                Author and article information

                S. Karger AG
                August 2005
                19 August 2005
                : 104
                : 1
                : 51-56
                Division of Cardiology, Sahlgrenska University Hospital, Göteborg, Sweden
                86525 Cardiology 2005;104:51–56
                © 2005 S. Karger AG, Basel

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                Page count
                Tables: 3, References: 12, Pages: 6
                General Cardiology

                General medicine, Neurology, Cardiovascular Medicine, Internal medicine, Nephrology

                Time trend, Chest pain


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