Key result
Adding hs-CRP to the HEART score improves 30-day MACE prediction to an AUC of ~0.90.
Why the study?
This study aimed to explore the predictive value of combining the HEART score with hypersensitive C-reactive protein for 30-day major adverse cardiovascular events in patients presenting with acute chest pain.
Does combining the HEART score with hypersensitive C-reactive protein (hs-CRP) improve the prediction of 30-day major adverse cardiovascular events compared to either test alone in patients presenting with acute chest pain?
Cohort (n=103)
No
Does combining the HEART score with hypersensitive C-reactive protein (hs-CRP) improve the prediction of 30-day major adverse cardiovascular events compared to either test alone in patients presenting with acute chest pain?
Answers are grounded in this paper and cite their sources.
Adding plasma hs-CRP measurement to the standard clinical HEART score significantly improves 30-day MACE risk stratification in emergency department patients presenting with acute chest pain.
Purpose. This study aimed to explore the predictive value of the HEART score combined with hypersensitive C-reactive protein (hs-CRP) for 30 d major adverse cardiovascular events (MACEs) in patients with acute chest pain. Methods. 103 patients with acute chest pain admitted to the emergency department of our hospital from May 2020 to May 2022 were selected as the study subjects. The patients’ HEART score and plasma hs-CRP level were recorded. The patients were followed up for 30 d to observe whether MACE occurred. Results. Among 103 patients with acute chest pain, MACE occurred in 8 cases within 30 d of follow-up, and the probability of MACE was 7.76%. There was a statistically significant difference in 30 d MACE risk among patients with different HEART score stratification ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mi>P</a:mi> <a:mo><</a:mo> <a:mn>0.05</a:mn> </a:math> ). The age, HEART score, and hs-CRP levels of patients in the MACE group were higher than those in the non-MACE group ( <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mi>P</c:mi> <c:mo><</c:mo> <c:mn>0.05</c:mn> </c:math> ). The HEART score and the hs-CRP level were independent risk factors for 30 d MACE in patients with acute chest pain ( <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mi>P</e:mi> <e:mo><</e:mo> <e:mn>0.05</e:mn> </e:math> ). The AUC of the HEART score combined with hs-CRP in the occurrence of 30 d MACE in patients with acute chest pain was 0.901, which was significantly higher than 0.720 and 0.758 of single detection. Conclusion. The HEART score combined with hs-CRP can better predict the occurrence of 30 d MACE in patients with acute chest pain.
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Lin et al. (2022) conducted a cohort in Acute chest pain (n=103). HEART score combined with plasma hypersensitive C-reactive protein (hs-CRP) vs. Single detection of HEART score alone or hs-CRP alone was evaluated on 30-day major adverse cardiovascular events (MACE: all-cause death, myocardial infarction, unstable angina, emergency revascularization, cardiogenic shock, and cardiac arrest/ventricular fibrillation) (AUC 0.901, p=<0.05). Combining the HEART score with hs-CRP achieved an AUC of 0.901 for predicting 30-day MACE in acute chest pain patients, outperforming the HEART score alone (0.720) and hs-CRP alone (0.758).
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