Original Contributions
Cholesterol Screening in an ED-Based Chest Pain Unit*,**

Presented at the Society of Academic Emergency Medicine Annual Meeting, Atlanta, GA, May 2001.
https://doi.org/10.1053/ajem.2002.34962Get rights and content

Abstract

To evaluate the prevalence of dyslipidemia in patients who are evaluated in a chest pain evaluation unit (CPEU) a prospective study of all patients admitted to our CPEU from January 1 to December 31, 1999 was conducted. Serum total cholesterol (TC) and high density lipoprotein (HDL) levels were obtained unless prior levels were known or at the discretion of the attending physician. Both TC and HDL were tested in 606 (59%) patients. Abnormal lipid levels were reported in 306 (50%) patients. Of these, 86 had both abnormal TC and HDL. Isolated low HDL levels were found in 60 of the patients and TC alone was abnormal in 160. Of the 246 patients with abnormal TC, 169 (69%) had borderline high levels (200-239 mg/dL) and 77 (31%) had high levels (≥240 mg/dL). Our study shows a high prevalence of abnormal lipid levels in patients, as identified by a screening protocol in our CPEU. (Am J Emerg Med 2002;20:510-512. Copyright 2002, Elsevier Science (USA). All rights reserved.)

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

References (27)

  • MS Lauer et al.

    Impaired heart rate response to graded exercise. Prognostic implications of chronotropic incompetence in the framingham heart study

    Circulation

    (1996)
  • S Perreault et al.

    Impact of treating dyslipidemia or hypertension to reduce the risk of death from coronary artery disease

    CMAJ

    (1999)
  • West of Scotland Coronary Prevention Study

    Identification of high-risk groups and comparison with other cardiovascular Intervention trials

    Lancet

    (1996)
  • Cited by (0)

    *

    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]

    **

    0735-6757/02/2006-0004$35.00/0

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