Key result
HEART score moderately predicts one-month MACE in acute chest pain with an AUC of ~0.80.
Why the study?
Screening high-risk patients with acute chest pain and accelerating their treatment can reduce the burden of ACS, but the accuracy of HEART score for predicting one-month MACE needed evaluation.
Does the HEART score accurately predict one-month major adverse cardiac events in patients presenting to the emergency department with acute chest pain?
Cross-Sectional (n=240)
Does the HEART score accurately predict one-month major adverse cardiac events in patients presenting to the emergency department with acute chest pain?
The HEART score demonstrates moderate diagnostic accuracy (AUC 0.796) for predicting one-month major adverse cardiac events in patients presenting to the emergency department with acute chest pain.
Answers are grounded in this paper and cite their sources.
Supports HEART score for ED chest pain triage; cross-sectional data leaves open need for prospective validation before practice change.
INTRODUCTION: Screening of high-risk patients and accelerating their therapeutic procedures can reduce the burden of acute coronary syndrome (ACS). This study aimed to evaluate the accuracy of HEART score in predicting the risk of one-month major adverse cardiac events (MACE) in these patients. METHODS: In this prospective cross-sectional study, the accuracy of HEART score in patients over 18 years old who presented to emergency department following acute chest pain, was evaluated during a 21-month period. Each patient was followed up regarding the incidence of MACE for one month via phone call and the hospital's integrated health information system. RESULTS: 240 cases with the mean age of 60.50 ± 16.07 years were studied (56.3% male). MACE was observed in 77 (32.1%) cases. The most common MACE was percutaneous coronary artery revascularization (PCAR) (12.9%). The mean HEART score of studied cases was 4.74 ± 2.12. The mean score of cases with MACE was significantly higher than others (6.25 ± 1.97 versus 4.03 ± 1.79; p < 0.0001). Based on this score, the risk of MACE was high in 34 (14.2%), moderate in 118 (49.2%), and low in 88 (36.7%) cases. The incidence of one-month MACE was 85.3% in high-risk cases, 35.6% in moderate one, and 6.8% in low-risk cases based on HEART score. The area under the ROC curve of HEART score in predicting the risk of MACE was 0.796 (95% CI: 0.736 - 0.856). The best cut off point of HEART score in this regard was calculated as 4.5. The sensitivity and specificity of this score in 4.5 cut off were 83.11% (95% CI: 72.49 - 90.35) and 66.25% (95% CI: 58.38 - 73.35), respectively. CONCLUSION: Based on the findings of the present study the mean HEART score of ACS patients with one-month MACE was significantly higher than others and the incidence of MACE in high-risk patients was significantly higher. But the overall accuracy of score in predicting one-month MACE in ACS patients was in moderate range.
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Alimohammadi et al. (2021) conducted a cross-sectional in Acute chest pain (n=240). HEART score was evaluated on One-month major adverse cardiac events (MACE) (AUC 0.796, 95% CI 0.736 - 0.856). The HEART score demonstrated moderate accuracy in predicting one-month MACE in patients with acute chest pain, with an area under the ROC curve of 0.796 (95% CI 0.736-0.856).
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