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Chest Pain in the ED: More Referrals for Cardiac Tests Not Tied to Better Outcomes

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For lower-risk patients with acute myocardial injury already ruled out for their chest pain, an increase in referrals for noninvasive cardiac testing (NICT) was not associated with improved outcomes, a retrospective cohort study suggested.


Compared with the low NICT referral group, there was no significant decrease in the adjusted hazard ratio of major adverse cardiac events (MACE) -- a composite of myocardial infarction, cardiac arrest, cardiogenic shock, or cardiac death -- for the intermediate referral group (adjusted HR 1.08, 95% CI 1.02-1.14) and high referral group (adjusted HR 1.05, 95% CI 0.99-1.11) within 2 years, reported Dustin Mark, MD, of Kaiser Permanente Medical Center in Oakland, California, and colleagues.

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