Key result
Among 200 patients admitted to the emergency department with chest pain and a low-risk HEART score of 0-3, no major adverse cardiac events (0%) occurred during the 6-week follow-up period.
Why the study?
To determine the incidence of major adverse cardiac events within 6 weeks after discharge in ED chest pain patients with a HEART score of 0-3, and evaluate its role in discharge decisions for low-risk ACS patients.
Does a HEART score of 0-3 safely identify emergency department patients with chest pain who are at low risk for major adverse cardiac events?
Observational (n=200)
No
Does a HEART score of 0-3 safely identify emergency department patients with chest pain who are at low risk for major adverse cardiac events?
A HEART score of 0-3 effectively identifies emergency department patients with chest pain who are at very low risk for short-term major adverse cardiac events, supporting safe early discharge.
Supports safe early discharge for HEART score 0-3 patients; leaves open need for larger prospective validation.
Aim: In this study, we aimed to determine the incidence of major adverse cardiac events within 6 weeks after discharge of patients admitted to the emergency department (ED) with chest pain and a HEART score of 0-3, and to determine the role of the HEART score in the discharge decision of low-risk patients for acute coronary syndrome from the ED.Material and Methods: Out of 625 patients admitted to the ED with chest pain, 200 patients with a HEART score of 0-3 were included in the study.Results: Of the 200 patients included in the study, 199 (99.5%) were discharged from the ED, and 1 patient (0.5%) prediagnosed with unstable angina pectoris was hospitalized in the coronary intensive care unit of an external center.The patient did not undergo angiography in the coronary intensive care unit and was discharged after 24 hours of observation.Angiography was performed in 3 (1.5%) of 199 patients discharged from the ED and was recommended in 1 patient (0.5%) who refused it.Coronary artery disease was detected in 1 of 3 patients who underwent angiography, but a stent was not placed.The angiography results of 2 patients were evaluated as normal.No major adverse cardiac events were seen in any of the 200 patients (0%) at the end of the 6-week follow-up period.Discussion: The HEART score can guide the emergency physicians in making decisions about the discharge of patients admit to ED with chest pain and at low risk of developing an acute coronary syndrome.
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Doğan et al. (2023) conducted an observational in Chest pain with suspected acute coronary syndrome (n=200). HEART score 0-3 was evaluated on Major adverse cardiac events (MACE) at 6 weeks. Among 200 patients admitted to the emergency department with chest pain and a low-risk HEART score of 0-3, no major adverse cardiac events (0%) occurred during the 6-week follow-up period.
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