Why the study?
Does the HEART score with a single contemporary troponin result improve prediction of 30-day MACE compared to GRACE and TIMI scores in chest pain patients in the emergency department?
Does the HEART score with a single contemporary troponin result improve prediction of 30-day MACE compared to GRACE and TIMI scores in chest pain patients in the emergency department?
A HEART score of ≤3 combined with a single contemporary troponin result provides excellent sensitivity and negative predictive value for 30-day MACE, supporting its use for safe discharge of chest pain patients from the emergency department.
May support early ED discharge in low-risk chest pain; leaves open need for prospective validation versus TIMI/GRACE.
HEART outperformed both TIMI and GRACE in overall discriminative capacity for 30-day MACE. Using a single contemporary cTn at presentation, a HEART score of ≤3 demonstrated sensitivity and NPV of ≥99.5% for 30-day MACE. These results reach the threshold for a safe discharge strategy but should be interpreted thoughtfully in light of other work.
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Reaney et al. (2018) studied this question.
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