Pre-test probability risk scores and their use in contemporary management of patients with chest pain: One year stress echo cohort study

ObjectivesTo compare how patients with chest pain would be investigated, based on the two guidelines available for UK cardiologists, on the management of patients with stable chest pain. The UK National Institute of Clinical Excellence (NICE) guideline which was published in 2010 and the European society of cardiology (ESC) guideline published in 2013. Both guidelines utilise pre-test probability risk scores, to guide the choice of investigation.DesignWe undertook a large retrospective study to investigate the outcomes of stress echocardiography.SettingA large tertiary centre in the UK in a contemporary clinical practice.ParticipantsTwo thirds of the patients in the cohort were referred from our rapid access chest pain clinics.ResultsWe found that the NICE risk score overestimates risk by 20% compared to the ESC Risk score. We also found that based on the NICE guidelines, 44% of the patients presenting with chest pain, in this cohort, would have been investigated invasively, with diagnostic coronary angio...