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Patients benefited from follow-up care after evaluation for chest pain
Following up with a cardiologist after discharge from the ED for chest pain reduced risk for all-cause death and MI by 21% in high-risk patients, according to new data published in Circulation.
However, in an observational study conducted in Ontario, Canada, researchers found that only 17% of 56,767 high-risk patients (mean age, 66 years; 53% men) visited a cardiologist within 30 days of admission to the ED for chest pain from 2004 to 2010. Fifty-eight percent visited a primary care physician only and 25% did not follow up with any physician.
Among patients who visited cardiologists, the rate of death or MI was 5.5% (95% CI, 5-5.9) vs. 7.7% (95% CI, 7.4-7.9) among those who followed up with a PCP and 8.6% (95% CI, 8.2-9.1) among those who did not follow up with any physician. Results also revealed a significantly lower adjusted HR after cardiologist follow-up when compared with PCP (HR=0.85; 95% CI, 0.78-0.92) and no physician (HR=0.79; 95% CI, 0.71-0.88) follow-up.
Data also showed that follow-up with a cardiologist resulted in more diagnostic testing, medical therapy and coronary revascularization.
“Being discharged from the emergency department is reassuring for patients, but it is critical that they follow up with their doctor to reduce their risks of future heart attacks or premature death,” researcher Dennis T. Ko, MD, MSc, of the Institute for Clinical Evaluative Services and Sunnybrook Health Sciences Center in Toronto, said in a press release. “Patients need to advocate for themselves and physicians need to be more diligent about arranging follow-up care.”
Disclosure: The researchers report no relevant financial disclosures.