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After Chest Pain, Outcomes Are Better With Cardiologist's Care

After Chest Pain, Outcomes Are Better With Cardiologist's Care

Follow-up within 30 days of ER visit was associated with decreased risk of death

TUESDAY, April 2 (HealthDay News) -- Patients with high cardiovascular risk seen for chest pain have better outcomes if they receive follow-up from a cardiologist rather than a primary care physician or no physician follow-up, according to a study published online April 1 issue of Circulation.

Andrew Czarnecki, M.D., from the University of Toronto in Ontario, Canada, and colleagues analyzed clinical outcomes from 56,767 patients (mean age, 66 years) evaluated in the emergency department for chest pain and without adverse clinical outcomes 30 days post-discharge, who were considered to be at high risk due to diabetes mellitus or established cardiovascular disease.

The researchers found that after one year, the rate of death or myocardial infarction was 5.5 percent for patients followed up by cardiologists, 7.7 percent for patients followed up by primary care physicians, and 8.6 percent for patients who received no physician follow up. After adjusting for possible confounding factors, patients followed up by cardiologists had a significantly lower risk of death or myocardial infarction compared with patients followed up by primary care physicians (hazard ratio 0.85) or no physician (hazard ratio 0.79).

"We demonstrated a significant gap in the transition of care for chest pain patients after discharge from the emergency department," the authors wrote. "Follow-up with a cardiologist within 30 days of emergency department visit was associated with a decreased risk of all-cause mortality or hospitalization for myocardial infarction at one year compared with primary care physician or no physician follow-up."

Abstract (http://circ.ahajournals.org/content/127/13/1386.abstract?sid=a80233bf-c9f6-4e65-8764-91210eb8bec8 )Full Text (subscription or payment may be required) (http://circ.ahajournals.org/content/127/13/1386.full )