Chest pain in primary care

Study design

The study is set within the CALIBER dataset which links primary care data from the Clinical Practice Research Datalink (CPRD) for 2000-2010 to the national registry of acute coronary syndromes (MINAP), cause-specific mortality data from the Office of National Statistics, and Hospital Episode Statistics (HES) data. This is a cohort study of patients newly presenting with chest pain who either do not receive a cardiovascular diagnosis or receive a diagnosis of angina. Patients are categorised based on initial chest pain record (attributed to non-coronary cause, cause unattributed, and angina). Chest pain consultations for the following 6 months are used to define a patient’s short term trajectory of chest pain symptoms. Patients will then be followed for a further 5 years (or until death or end of records) to identify cardiovascular outcomes.

Primary objective

The overall aim is to assess the risk of long term cardiovascular events in patients presenting with new chest pain which is unattributed to cardiovascular disease, and to assess whether the short term patterns (trajectories) of health care use for chest pain improve identification of those at increased risk of such events.