The modified HEART risk score incorporating high-sensitivity cardiac troponin I demonstrated excellent discriminative power for predicting 3-month MACE with a C-statistic of 0.84.
Cohort (n=1,300)
No
Does a modified HEART risk score using high-sensitivity cardiac Troponin I accurately predict 3-month MACE in emergency department patients with suspected NSTE-ACS?
A modified HEART score incorporating high-sensitivity troponin I effectively stratifies emergency department patients with suspected NSTE-ACS into distinct risk categories for 3-month major adverse cardiac events.
Estimación del efecto: C-statistic 0.84 (95% CI 0.82-0.87)
valor p: p=<0.001
OBJECTIVE: To validate a modified HEART History, Electrocardiograph (ECG), Age, Risk factors and Troponin risk score in chest pain patients with suspected non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in the emergency department (ED). METHODS: This retrospective cohort study used a prospectively acquired database and chest pain patients admitted to the emergency department with suspected NSTE-ACS were enrolled. Data recorded on arrival at the ED were used. The serum sample of high-sensitivity cardiac Troponin I other than conventional cardiac Troponin I used in the HEART risk score was tested. The modified HEART risk score was calculated. The end point was the occurrence of major adverse cardiac events (MACE) defined as a composite of acute myocardial infarction (AMI), percutaneous intervention (PCI), coronary artery bypass graft (CABG), or all-cause death, within three months after initial presentation. RESULTS: A total of 1,300 patients were enrolled. A total of 606 patients (46.6%) had a MACE within three months: 205 patients (15.8%) were diagnosed with AMI, 465 patients (35.8%) underwent PCI, and 119 patients (9.2%) underwent CABG. There were 10 (0.8%) deaths. A progressive, significant pattern of increasing event rate was observed as the score increased (P < 0.001 by χ (2) for trend). The area under the receiver operating characteristic curve was 0.84. All patients were classified into three groups: low risk (score 0-2), intermediate risk (score 3-4), and high risk (score 5-10). Event rates were 1.1%, 18.5%, and 67.0%, respectively (P < 0.001). CONCLUSIONS: The modified HEART risk score was validated in chest pain patients with suspected NSTE-ACS and may complement MACE risk assessment and patients triage in the ED. A prospective study of the score is warranted.
Ma et al. (Fri,) conducted a cohort in Suspected non-ST-segment elevation acute coronary syndrome (NSTE-ACS) (n=1,300). Modified HEART risk score (incorporating hs-cTnI) was evaluated on Major adverse cardiac events (MACE) within 3 months (C-statistic 0.84, 95% CI 0.82-0.87, p=<0.001). The modified HEART risk score incorporating high-sensitivity cardiac troponin I demonstrated excellent discriminative power for predicting 3-month MACE with a C-statistic of 0.84.