{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T03:33:03Z","timestamp":1747193583073,"version":"3.40.5"},"reference-count":2,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiology"],"published-print":{"date-parts":[[2022]]},"abstract":"<jats:p>&lt;b&gt;&lt;i&gt;Background:&lt;\/i&gt;&lt;\/b&gt; Patients with suspected non-ST-elevation acute coronary syndrome (NSTE-ACS) assigned to the \u201cobserve\u201d zone of the European Society of Cardiology (ESC) 0\/1-h algorithm form a heterogeneous group known to have an unfavourable prognosis. We aim to elucidate the clinical characteristics and management of these patients and generate a model that is predictive of a coronary diagnosis at index visit to the emergency department (ED). &lt;b&gt;&lt;i&gt;Methods:&lt;\/i&gt;&lt;\/b&gt; A retrospective observational cohort study, including adult patients presenting to the ED with suspected NSTE-ACS assigned to the \u201cobserve\u201d zone of the ESC 0\/1-h algorithm. Multivariable logistic regression analysis was performed for the prediction of a coronary diagnosis. Internal validation was performed using bootstrap resampling. &lt;b&gt;&lt;i&gt;Results:&lt;\/i&gt;&lt;\/b&gt; A total of 750 patients were included; mean age 66 \u00b1 13 years, 35% women, 50% with prior history of coronary artery disease (CAD). In 372 (50%) patients a diagnosis was established within 30 days of index presentation, of whom 169 (45%) patients had a coronary-related event. Multivariable logistic regression analysis generated a 12-point risk score incorporating 5 variables for the prediction of such event, including type of angina, chest pain occurring during inspiration, prior history of CAD, ST-segment deviation on electrocardiogram, and estimated glomerular filtration rate &amp;#x3c;60. The final model had an optimism-corrected c-statistic of 0.78 (95% confidence interval [CI]: 0.74\u20130.82). A score &amp;#x3c;6 ruled out a coronary event in 276 (37%) patients, with a sensitivity and negative predictive value of 90% (95% CI: 84\u201394) and 94% (91\u201396), respectively. &lt;b&gt;&lt;i&gt;Conclusion:&lt;\/i&gt;&lt;\/b&gt; A score &amp;#x3c;6 identifies patients at low risk of a coronary diagnosis and can guide clinical decision-making in choosing the appropriate diagnostic test. <\/jats:p>","DOI":"10.1159\/000523718","type":"journal-article","created":{"date-parts":[[2022,2,23]],"date-time":"2022-02-23T22:00:41Z","timestamp":1645653641000},"page":"251-260","source":"Crossref","is-referenced-by-count":1,"title":["Development and Internal Validation of a Practical Model to Identify Observe Patients of the European Society of Cardiology 0\/1-h Algorithm at Low Risk of a Coronary Diagnosis"],"prefix":"10.1159","volume":"147","author":[{"given":"Murat","family":"Arslan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric","family":"Boersma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Admir","family":"Dedic","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6727-8635","authenticated-orcid":false,"given":"Eric A.","family":"Dubois","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2022,2,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19960229)15:4%3c361::AID-SIM168%3e3.0.CO;2-4"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/BF03086144"}],"container-title":["Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/523718","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/523718","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T15:54:05Z","timestamp":1745423645000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000523718"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":2,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,7,1]]},"published-print":{"date-parts":[[2022,7,5]]}},"URL":"https:\/\/doi.org\/10.1159\/000523718","archive":["Portico"],"relation":{},"ISSN":["0008-6312","1421-9751"],"issn-type":[{"type":"print","value":"0008-6312"},{"type":"electronic","value":"1421-9751"}],"subject":[],"published":{"date-parts":[[2022]]}}}