Establishment of a Chest Pain Unit in a Multidisciplinary Hospital: A Retrospective Observational Analysis
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By
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Ayagyoz Umbetzhanova
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Gulmira Derbissalina
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Dias Vakpayev
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Zhanagul Bekbergenova
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Vitaliy Koikov
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July 8, 2026
Clinical Scorecard: Establishment of a Chest Pain Unit in a Multidisciplinary Hospital: A Retrospective Observational Analysis
At a Glance
| Category | Detail |
|---|
| Condition | Acute Coronary Syndrome (ACS) |
| Key Mechanisms | Standardized assessment, electrocardiography, serial cardiac troponin measurements, HEART pathway risk stratification |
| Target Population | Patients presenting with acute chest pain |
| Care Setting | Multidisciplinary hospital emergency department |
Key Highlights
- Higher rates of AMI identification in CPU group (37.6% vs. 25.1%)
- Increased PCI use in CPU group (OR 1.43, p < 0.001)
- No significant difference in mortality between groups (2.4% vs. 2.2%)
- Higher direct treatment costs post-CPU implementation (p < 0.001)
- Diagnostic angiography more frequent in non-CPU group (OR 0.76, p = 0.02)
Guideline-Based Recommendations
Diagnosis
- Utilize standardized diagnostic pathways including serial electrocardiography and cardiac biomarker testing
Management
- Implement risk stratification tools like the HEART pathway for patient management
Monitoring & Follow-up
- Monitor in-hospital outcomes and treatment costs following CPU implementation
Risks
- Consider potential for increased treatment costs associated with CPU implementation
Patient & Prescribing Data
Patients with suspected ACS (ICD-10 I20–I22)
CPU pathways may improve diagnostic accuracy and management patterns
Clinical Best Practices
- Adopt CPU protocols to optimize evaluation and management of acute chest pain
- Incorporate risk stratification tools to enhance patient safety and operational efficiency
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