{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T06:36:05Z","timestamp":1780468565174,"version":"3.54.1"},"reference-count":27,"publisher":"BMJ","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Heart"],"published-print":{"date-parts":[[2007,4]]},"abstract":"\n Objective:<\/jats:bold> To determine whether rapid access chest pain clinics are clinically effective by comparison of coronary event rates in patients diagnosed with angina with rates in patients diagnosed with non-cardiac chest pain and the general population.<\/jats:p>\n \n Design:<\/jats:bold> Multicentre cohort study of consecutive patients with chest pain attending the rapid access chest pain clinics (RACPCs) of six hospitals in England.<\/jats:p>\n \n Participants:<\/jats:bold> 8762 patients diagnosed with either non-cardiac chest pain (n\u200a=\u200a6396) or incident angina without prior myocardial infarction (n\u200a=\u200a2366) at first cardiological assessment, followed up for a median of 2.57 (interquartile range 1.96\u20134.15) years.<\/jats:p>\n \n Main outcome measures:<\/jats:bold> Primary end point\u2014death due to coronary heart disease (International Classification of Diseases (ICD)10 I20\u2013I25) or acute coronary syndrome (non-fatal myocardial infarction (ICD10 I21\u2013I23), hospital admission with unstable angina (I24.0, I24.8, I24.9)). Secondary end points\u2014all-cause mortality (ICD I20), cardiovascular death (ICD10 I00\u2013I99), or non-fatal myocardial infarction or non-fatal stroke (I60\u2013I69).<\/jats:p>\n \n Results:<\/jats:bold> The cumulative probability of the primary end point in patients diagnosed with angina was 16.52% (95% confidence interval (CI) 14.88% to 18.32%) after 3 years compared with 2.73% (95% CI 2.29% to 3.25%) in patients with non-cardiac chest pain. Coronary standardised mortality ratios for men and women with angina aged <65 years were 3.52 (95% CI 1.98 to 5.07) and 4.39 (95% CI 1.14 to 7.64). Of the 599 patients who had the primary end point, 194 (32.4%) had been diagnosed with non-cardiac chest pain. These patients were younger, less likely to have typical symptoms, more likely to be south Asian and more likely to have a normal resting electrocardiogram than patients with angina who had the primary end point.<\/jats:p>\n \n Conclusion:<\/jats:bold> RACPCs are successful in identifying patients with incident angina who are at high coronary risk, but there is a need to reduce misdiagnosis and improve outcomes in patients diagnosed with non-cardiac chest pain who accounted for nearly one third of cardiac events during follow-up.<\/jats:p>","DOI":"10.1136\/hrt.2006.090894","type":"journal-article","created":{"date-parts":[[2006,6,21]],"date-time":"2006-06-21T20:52:19Z","timestamp":1150923139000},"page":"458-463","source":"Crossref","is-referenced-by-count":120,"title":["How effective are rapid access chest pain clinics? Prognosis of incident angina and non-cardiac chest pain in 8762 consecutive patients"],"prefix":"10.1136","volume":"93","author":[{"given":"N","family":"Sekhri","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G S","family":"Feder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C","family":"Junghans","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Hemingway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A D","family":"Timmis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2006,6,21]]},"reference":[{"key":"2025092001534039000_93.4.458.1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9149(72)90624-8"},{"key":"2025092001534039000_93.4.458.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.326.7379.20"},{"key":"2025092001534039000_93.4.458.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00392-003-0965-9"},{"key":"2025092001534039000_93.4.458.4","doi-asserted-by":"publisher","DOI":"10.1136\/heart.89.8.848"},{"key":"2025092001534039000_93.4.458.5","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.73.2.193"},{"key":"2025092001534039000_93.4.458.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.1.6016.981"},{"key":"2025092001534039000_93.4.458.7","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/91.5.339"},{"key":"2025092001534039000_93.4.458.8","doi-asserted-by":"publisher","DOI":"10.1136\/pmj.78.915.43"},{"key":"2025092001534039000_93.4.458.9","unstructured":"Department of Health. National Service Framework for Coronary Heart Disease: modern standards and service models. London: Department of Health, 2000."},{"key":"2025092001534039000_93.4.458.10","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1136\/hrt.80.2008.1S","volume":"80","year":"1998","journal-title":"Heart"},{"key":"2025092001534039000_93.4.458.11","first-page":"420","volume":"32","year":"1998","journal-title":"J R Coll Physicians Lond"},{"key":"2025092001534039000_93.4.458.12","unstructured":"Office for National Statistics. A brief history of the ONS. http:\/\/www.bized.ac.uk\/dataserv\/ons\/onshistory.htm (accessed 15 Sept 2006)."},{"key":"2025092001534039000_93.4.458.13","unstructured":"Anon. NHS-wide clearing system. http:\/\/www.connectingforhealth.nhs.uk\/nwcs\/ (accessed 15 Sept 2006)."},{"key":"2025092001534039000_93.4.458.14","unstructured":"Anon. Patient Information Advisory Group. http:\/\/www.advisorybodies.doh.gov.uk\/piag\/ (accessed 15 Sept 2006)."},{"key":"2025092001534039000_93.4.458.15","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16980-8"},{"key":"2025092001534039000_93.4.458.16","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa042739"},{"key":"2025092001534039000_93.4.458.17","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMe048255"},{"key":"2025092001534039000_93.4.458.18","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehi171"},{"key":"2025092001534039000_93.4.458.19","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(02)02834-6"},{"key":"2025092001534039000_93.4.458.20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp042317"},{"key":"2025092001534039000_93.4.458.21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.330.7499.1059"},{"key":"2025092001534039000_93.4.458.22","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13636-7"},{"key":"2025092001534039000_93.4.458.23","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa042330"},{"key":"2025092001534039000_93.4.458.24","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2004.03.032"},{"key":"2025092001534039000_93.4.458.25","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(99)00265-X"},{"key":"2025092001534039000_93.4.458.26","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2000.2305"},{"key":"2025092001534039000_93.4.458.27","doi-asserted-by":"publisher","DOI":"10.1001\/jama.295.12.1404"}],"container-title":["Heart"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/hrt.2006.090894","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,20]],"date-time":"2025-09-20T08:53:47Z","timestamp":1758358427000},"score":1,"resource":{"primary":{"URL":"https:\/\/heart.bmj.com\/lookup\/doi\/10.1136\/hrt.2006.090894"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,6,21]]},"references-count":27,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2007,3,30]]},"published-print":{"date-parts":[[2007,4]]}},"alternative-id":["10.1136\/hrt.2006.090894"],"URL":"https:\/\/doi.org\/10.1136\/hrt.2006.090894","relation":{},"ISSN":["1355-6037","1468-201X"],"issn-type":[{"value":"1355-6037","type":"print"},{"value":"1468-201X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,6,21]]}}}