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New Imaging Test Helps ER Docs Separate out Faster Patients in Danger of Heart Attack from Other ER Patients

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Press Release Date: November 10, 1999

At least 240,000 unnecessary hospitalizations per year for patients who come to emergency departments with chest pain or symptoms suggestive of a heart attack and have a non-diagnostic EKG could be safely avoided according to a new study funded by the Agency for Health Care Policy and Research (AHCPR). This represents a potential 20 percent reduction in the unnecessary admission rate of patients who turn out not to have threatened or true heart attacks. Preliminary data, when projected nationally, show a conservative, estimated annual savings of $85 million in actual costs associated with the lowered admission rate. The study, the ERASE Chest Pain Trial, was conducted by Harry P. Selker, M.D., James E. Udelson, M.D., and Joni R. Beshansky, R.N., M.P.H., of the New England Medical Center and Tufts University School of Medicine in Boston, MA. The results were released today at the 72nd American Heart Association meeting in Atlanta, GA.

This was the first time the imaging test (known as a sestamibi scan which traces the blood flow to the heart) was tested in a prospective clinical effectiveness trial. The trial lasted over 20 months, with 2,456 patients randomized to either receive an imaging test during patient evaluation in ER, or to receive the usual ER care (no imaging test). Patients included in the study were those most likely to be admitted unnecessarily: those patients having a normal or non-diagnostic initial EKG while at the same time exhibiting symptoms of a heart attack.

More than 7 million patients show up at ERs because of chest pain or other symptoms suggestive of heart attack. Although 75 percent of these patients are not actually having heart attacks, nonetheless, most are admitted to the hospital. This accounts for more than 3 million unnecessary hospitalizations per year and billions of dollars in costs.

To arrange interviews with Drs. Selker and Udelson, contact Joni Beshansky at (617) 636-5065.

For additional information, please contact AHCPR Public Affairs, (301) 427-1364.

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