Key result
Among 1,766 patients with chest pain, none of the 136 patients with a HEART score of 0 or 1 had an elevated troponin level, suggesting a small efficiency gain for early discharge.
Patients with a HEART score of 0 or 1 had no elevated troponin levels, suggesting a potential small efficiency gain by early discharge without troponin testing.
Letters7 November 2017Using the HEART Score in Patients With Chest Pain in the Emergency DepartmentJudith M. Poldervaart, MD, PhD, Johannes B. Reitsma, MD, PhD, Jacob Six, MD, PhD, Rolf F. Veldkamp, MD, PhD, and Arno W. Hoes, MD, PhDJudith M. Poldervaart, MD, PhDFrom University Medical Center Utrecht, Utrecht; Zuwe Hofpoort Hospital, Woerden; and Haaglanden Medical Center, The Hague, the Netherlands., Johannes B. Reitsma, MD, PhDFrom University Medical Center Utrecht, Utrecht; Zuwe Hofpoort Hospital, Woerden; and Haaglanden Medical Center, The Hague, the Netherlands., Jacob Six, MD, PhDFrom University Medical Center Utrecht, Utrecht; Zuwe Hofpoort Hospital, Woerden; and Haaglanden Medical Center, The Hague, the Netherlands., Rolf F. Veldkamp, MD, PhDFrom University Medical Center Utrecht, Utrecht; Zuwe Hofpoort Hospital, Woerden; and Haaglanden Medical Center, The Hague, the Netherlands., and Arno W. Hoes, MD, PhDFrom University Medical Center Utrecht, Utrecht; Zuwe Hofpoort Hospital, Woerden; and Haaglanden Medical Center, The Hague, the Netherlands.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/L17-0436 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Moumneh and colleagues suggest another possible explanation for the small effect on health care resources that we observed and relate it to "troponin measurement for all patients with chest pain, even those with a low clinical probability of acute coronary syndrome." In the data set of the HEART-Impact trial, 136 of the 1766 patients (7.7%) had a HEART score of 0 (n = 30) or 1 (n = 106); none of the 136 patients had an elevated troponin level, suggesting a small efficiency gain of these 7.7% of patients who may be discharged early from the emergency department without ... Author, Article, and Disclosure InformationAffiliations: From University Medical Center Utrecht, Utrecht; Zuwe Hofpoort Hospital, Woerden; and Haaglanden Medical Center, The Hague, the Netherlands.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M16-1600. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoEffect of Using the HEART Score in Patients With Chest Pain in the Emergency Department Judith M. Poldervaart , Johannes B. Reitsma , Barbra E. Backus , Hendrik Koffijberg , Rolf F. Veldkamp , Monique E. ten Haaf , Yolande Appelman , Herman F.J. Mannaerts , Jan-Melle van Dantzig , Madelon van den Heuvel , Mohamed el Farissi , Bernard J.W.M. Rensing , Nicolette M.S.K.J. Ernst , Ineke M.C. Dekker , Frank R. den Hartog , Thomas Oosterhof , Ghizelda R. Lagerweij , Eugene M. Buijs , Maarten W.J. van Hessen , Marcel A.J. Landman , Roland R.J. van Kimmenade , Luc Cozijnsen , Jeroen J.J. Bucx , Clara E.E. van Ofwegen-Hanekamp , Maarten-Jan Cramer , A. Jacob Six , Pieter A. Doevendans , and Arno W. Hoes Using the HEART Score in Patients With Chest Pain in the Emergency Department Thomas Moumneh , Delphine Douillet , and Pierre-Marie Roy Metrics Cited byReduced Microvascular Blood Volume as a Driver of Coronary Microvascular Disease in Patients With Non-obstructive Coronary Artery Disease: Rationale and Design of the MICORDIS StudyThe HEART score is useful to predict cardiovascular risks and reduces unnecessary cardiac imaging in low-risk patients with acute chest pain 7 November 2017Volume 167, Issue 9Page: 688KeywordsAcute coronary syndromeAlgorithmsDisclosureEmergency departmentHealth careHeartIschemiaLongitudinal studiesSafetyTroponin ePublished: 7 November 2017 Issue Published: 7 November 2017 Copyright & PermissionsCopyright © 2017 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...
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Poldervaart et al. (2017) conducted a letter in Chest pain (n=1,766). HEART score was evaluated on Elevated troponin level. Among 1,766 patients with chest pain, none of the 136 patients with a HEART score of 0 or 1 had an elevated troponin level, suggesting a small efficiency gain for early discharge.
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