OBJECTIVES: To describe the characteristics and outcome of patients hospitalized for acute chest pain in relation to whether they were admitted to the coronary care unit (CCU) or not. DESIGN: Prospective observational study with a follow-up of 2 years. SETTING: Sahlgrenska University Hospital in Göteborg, Sweden. SUBJECTS: All patients hospitalized due to acute chest pain during 6 months. MAIN OUTCOME MEASURES: Mortality, use of medical resources, complications and previous history. RESULTS: In all 1.592 patients were admitted to hospital for chest pain, of whom 1.136 (71%) were not directly admitted to the CCU. These patients differed from those directly admitted to the CCU, being older, including more women, having a higher prevalence of known congestive heart failure and a lower degree of initial suspicion of acute myocardial infarction (AMI). Among all patients with confirmed AMI only 58% were directly admitted to CCU. Overall, the occurrence of complications and the use of medical resources were less frequent in the patients not admitted to the CCU. The mortality during the subsequent 2 years was 16.8% for patients not admitted to the CCU and 18.5% for patients admitted to the CCU. When adjusting for various factors at baseline, patients admitted to the CCU had a relative risk of death during 2 years of follow-up being 1.23 0.87-1.73 (P=0.24) as compared with those not admitted to the CCU. CONCLUSION: In a Swedish university hospital, more than two thirds of patients hospitalized for acute chest pain were not directly admitted to the CCU. They differed from those admitted to the CCU in several aspects. However, their unadjusted and adjusted mortality during the subsequent 2 years did not significantly differ from those admitted to CCU.