6. Medical outcomes

Although thrombolytic therapy and primary angioplasty for thrombolytic ineligible patients have reduced mortality following acute myocardial infarction, consistent benefits have not yet been achieved. Delay in treatment, a major determinant of patient outcome, raises the mortality associated with heart attacks four-fold [39].

The best improvement in morbidity and mortality associated with myocardial infarction will be achieved when patients with prodromal unstable angina receive optimal treatment protocols, including antiplatelet and antithrombotic agents that are currently available to prevent progression to an acute myocardial infarction. Chest pain centers can accomplish this by providing a facility where patients come in at the earliest symptom of chest pain, are evaluated in a user-friendly environment, and promptly receive appropriate treatment.

The identification of a low-probability myocardial ischemic disease category (Track IV) is a pivotal aspect of the strategy employed by chest pain centers to reduce heart attack mortality. Development of this track, along with a community awareness campaign, opened the emergency room door to a large number of patients who present with mild chest pain symptoms. If these patients receive treatment at the prodromal unstable angina stage, mortality can be reduced by 50% [40].

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