RT Journal Article
SR Electronic
T1 Comparison of ESC and NICE guidelines for patients with suspected coronary artery disease: evaluation of the pre-test probability risk scores in clinical practice
JF Clinical Medicine
JO Clin Med
FD Royal College of Physicians
SP 234
OP 238
DO 10.7861/clinmedicine.15-3-234
VO 15
IS 3
A1 Ozan M Demir
A1 Peter Dobson
A1 Nikolaos D Papamichael
A1 Jonathan Byrne
A1 Sven Plein
A1 Khaled Alfakih
YR 2015
UL http://www.rcpjournals.org/content/15/3/234.abstract
AB The European Society of Cardiology (ESC) and UK National Institute for Health and Care Excellence (NICE) have recently published guidelines for investigating patients with suspected coronary artery disease (CAD). Both provide a risk score (RS) to assess the pre-test probability for CAD to guide clinicians to undertake the most effective investigation. The aim of the study was to establish whether there is a difference between the two RS models. We retrospectively reviewed records of 479 patients who presented to a UK district general hospital with chest pain between August 2011 and April 2013. The RS was calculated using ESC and NICE guidelines and compared. From the 479 patients, 277 (58%) were male and the mean age was 60 years. The mean RS was greater using NICE guidelines compared with ESC (66.3 vs 47.9%, 18.4% difference; p<0.0001). The difference in mean RS was smaller in patients with typical chest pain (13.0%). When we divided the cohort based on NICE criteria into ‘high’- and ‘low’-risk groups, the difference in the mean RS was 24.3% in the ‘high’-risk group (p<0.001) compared with 2.8% in the ‘low’-risk group. The UK NICE risk score model overestimates risk compared with the ESC model.