Original ContributionsCholesterol Screening in an ED-Based Chest Pain Unit*,**
Section snippets
Methods
An observational prospective study was performed on all patients admitted to our CPEU from January 1, 1999 to December 31, 1999. All patients presenting with chest pain suggestive of cardiac ischemia, but without initial objective evidence of an acute coronary syndrome and no other diagnoses to account for their symptoms are considered for admission to this unit. Serum total cholesterol (TC) and high density lipoprotein (HDL) were measured in all CPEU patients unless prior levels were known or
Results
A total of 1,035 patients were admitted to the CPEU during the study period. This group consisted of 302 (29%) patients on Medicare/Medi-Cal, 313 (30%) with local county-based insurance, 347 (34%) enrolled in an HMO, and 73 (7%) with unknown status. In this cohort, 97 met exclusion criteria of history of dyslipidemia. Of the remaining 938 patients, 660 (70%) received lipid screening. Also excluded were 54 (5%) patients with incomplete data, leaving a study group in which both TC and HDL were
Discussion
This study shows a high prevalence of abnormal lipid levels in men and women identified by a screening protocol in a CPEU. Our results support the concept of using this setting to identify patients who could benefit from intervention to manage abnormal serum lipids. Furthermore, this setting provides a unique opportunity to initiate this approach in our ethnically diverse, largely publicly insured population, a group that has traditionally received less than optimal management of cardiac risk
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Address reprint requests to Deborah B. Diercks, MD, Division of Emergency Medicine, University of California, Davis, Suite 2100 PSSB, 2315 Stockton Boulevard, Sacramento, CA 95817. E-mail: [email protected]
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