000			04171nam a22005777a 4500
008			240723s20242024 xxu||||| |||| 00| 0 eng d
022			_a1878-0938
024			_aS1553-8389(24)00114-3 [pii]
040			_aOvid MEDLINE(R)
099			_a38637194
245			_aFrom chest pain to coronary functional testing: Clinical and economic impact of coronary microvascular dysfunction.
251			_aCardiovascular Revascularization Medicine. 2024 Mar 28
252			_aCardiovasc Revasc Med. 2024 Mar 28
253			_aCardiovascular revascularization medicine : including molecular interventions
260			_c2024
260			_p2024 Mar 28
265			_saheadofprint
265			_tPublisher
266			_d2024-07-23
501			_aAvailable in print through MWHC library: 2002 - present
520			_aBACKGROUND: Coronary functional testing to formally diagnose coronary microvascular dysfunction (CMD) reduces cardiovascular events and alleviates angina. This study aims to investigate the extensive and complex journey that patients with CMD undergo, from the onset of chest pain to eventual diagnosis.
520			_aCONCLUSION: Timely identification of CMD offers promising opportunities for prompt symptom alleviation, accompanied by reduced visits to the emergency department, cardiovascular testing, invasive medical procedures, and consequently reduced healthcare expenses. Copyright © 2024. Published by Elsevier Inc.
520			_aMETHODS: Data from the Coronary Microvascular Disease Registry (CMDR) were analyzed, including information on the date of first documentation of chest pain, number of non-invasive and invasive tests the patient underwent, emergency department visits, and hospitalizations. In addition, we estimated the total cost per patient. A total of 61 patients with CMD diagnosis were included in this analysis.
520			_aRESULTS: Most patients in our cohort were older than 50 years of age. The median time from initial chest pain symptoms to diagnosis was 0.62 (interquartile range [IQR]: 0.06-2.96) years. During this period, patients visited the emergency department a median of 1.0 (IQR: 0.0-2.0) times. Diagnostic tests included 3.0 (IQR: 2.0-6.0) electrocardiograms, 3.0 (IQR: 0.0-6.0) high-sensitivity troponin tests, and 1.0 (IQR: 1.0-2.0) echocardiograms. Prior to diagnosis of CMD, 13 (21.3 %) patients had left heart catheterization without coronary functional testing. Non-invasive testing for ischemia was conducted in 43 (70.5 %) patients. Alternative non-cardiac diagnoses were given to 11 (18.0 %) patients during the diagnostic process, with referrals made to gastroenterology for 16 (26.2 %) and pulmonology for 10 (16.4 %) patients. The cost was almost _2000/patient.
546			_aEnglish
650			_zAutomated
650			_aIN PROCESS -- NOT YET INDEXED
651			_aMedStar Health Research Institute
651			_aMedStar Heart & Vascular Institute
651			_aMedStar Washington Hospital Center
656			_aAdvanced Cardiac Catheterization Research Fellowship
656			_aCardiovascular Disease Fellowship
657			_aJournal Article
700			_aBen-Dor, Itsik _bMHVI
700			_aCase, Brian C _bMHVI
700			_aChitturi, Kalyan _bMWHC _cAdvanced Cardiac Catheterization Research Fellowship _dDO
700			_aHashim, Hayder _bMHVI
700			_aHill, Andrew _bMWHC _cCardiovascular Disease Fellowship _dMD
700			_aLopez, Kassandra _bMHVI
700			_aMerdler, Ilan _bMHVI
700			_aOzturk, Sevket Tolga _bMHVI
700			_aReddy, Pavan _bMWHC _cAdvanced Cardiac Catheterization Research Fellowship _dMD
700			_aSawant, Vaishnavi _bMHVI
700			_aWaksman, Ron _bMHVI
700			_aWallace, Ryan _bMWHC _cCardiovascular Disease Fellowship _dMD
700			_aWeintraub, William S _bMHRI
700			_aZhang, Cheng _bMHVI
790			_aMerdler I, Wallace R, Hill AP, Chitturi KR, Medranda GA, Reddy P, Zhang C, Ozturk ST, Sawant V, Weintraub WS, Lopez K, Ben-Dor I, Waksman R, Hashim HD, Case BC
856			_uhttps://dx.doi.org/10.1016/j.carrev.2024.03.026 _zhttps://dx.doi.org/10.1016/j.carrev.2024.03.026
942			_cART _dArticle
999			_c14168 _d14168