Key result
Non-low-risk HEART scores linked to ~8-fold higher obstructive CAD odds, demonstrating better sensitivity than intermediate troponin.
Why the study?
Intermediate hsTnI concentrations have been suggested for downstream CTCA investigation, motivating a comparison between HEART score-guided and hsTnI-guided approaches for identifying obstructive CAD.
Does a HEART score-guided approach improve the identification of obstructive CAD compared to a hsTnI-guided approach in patients with suspected ACS without elevated hsTnI?
Cohort (n=433)
No
Does a HEART score-guided approach improve the identification of obstructive CAD compared to a hsTnI-guided approach in patients with suspected ACS without elevated hsTnI?
Odds Ratio: 8.5 (95% CI 4.59–15.75)
Absolute Event Rate: 41% vs 7.6%
p-value: p=<0.001
In patients with suspected ACS and non-elevated hsTnI, using the HEART score provides better sensitivity and negative predictive value than hsTnI concentration for identifying obstructive CAD on CTCA.
May support HEART score over hsTnI alone for obstructive CAD detection in suspected ACS; hypothesis-generating, needs prospective validation.
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Yoo et al. (2023) conducted a cohort in Suspected acute coronary syndrome with ruled-out myocardial infarction (n=433). Non-low-risk HEART score (≥4) vs. Low-risk HEART score (0-3) was evaluated on Presence of obstructive coronary artery disease on CTCA (OR 8.50, 95% CI 4.59-15.75, p=<0.001). A non-low-risk HEART score (≥4) was associated with higher odds of obstructive coronary artery disease (OR 8.50) compared to a low-risk score, demonstrating higher sensitivity than intermediate troponin concentrations.
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