Key result
HEART score outperforms TIMI for predicting 6-week MACE with a c-statistic of ~0.87 vs 0.61.
Why the study?
The HEART score is used for early risk assessment in patients with chest pain in emergency settings, but its impact compared to TIMI score needed evaluation.
Does the HEART score improve the prediction of major adverse cardiac events compared to the TIMI score in emergency department patients presenting with chest pain?
Cross-Sectional (n=200)
No
Does the HEART score improve the prediction of major adverse cardiac events compared to the TIMI score in emergency department patients presenting with chest pain?
The HEART score is a highly effective, rapid prognostic tool that outperforms the TIMI score for risk-stratifying emergency department patients with chest pain.
May support HEART over TIMI for ED chest pain triage; leaves open prospective validation before practice change.
Background and Objectives: The HEART score aids in the early assessment of risk in patients presenting with chest pain in emergency settings. Objective: To assess the impact of using the HEART score in patients presenting with chest pain in the emergency department. Patients and Methods: This prospective cross-sectional study was conducted at the emergency department of Shar Teaching Hospital, Sulaimani. From March 2024 to September 2024, two hundred patients with chest pain, aged 28-90 years (59.14±11.87 years), were enrolled. HEART and TIMI scores were calculated. Also, within 6 weeks of initial presentation major adverse cardiac events were documented. Results: Regarding the HEART score, most low-risk patients (86.7%, n=13) were discharged with follow-up, while 13.3% (n=2) underwent angiography. In the moderate-risk group, 36.2% (n=25) received angiography with medical therapy, and 55.1% (n=38) underwent percutaneous intervention. Among high-risk patients, 84.5% (n=98) underwent percutaneous intervention (p<0.001). The HEART score was significantly higher in MACE patients (7.69 ± 1.47) than in non-MACE patients (5.03 ± 1.77). Similarly, the TIMI score was higher in the MACE group (1.41 ± 2.12) compared to non-MACE patients (0.37 ± 1.08). C-statistics showed better performance of the HEART score (0.87) over TIMI (0.61) (p<0.001). Conclusion: The HEART score enhances decision-making in emergencies, outperforming radiation-based or invasive methods. Low scores indicate a lower acute coronary syndrome risk, while high scores predict a higher incidence of major adverse cardiovascular events. As a quick, reliable prognostic tool, it aids in efficient chest pain triage.
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Abdulkareem et al. (2026) conducted a cross-sectional in Chest pain (n=200). HEART score vs. TIMI score was evaluated on Diagnostic discriminative ability (c-statistic) for major adverse cardiac events (MACE) within 6 weeks (c-statistic 0.87, p=<0.001). The HEART score demonstrated significantly better discriminative performance than the TIMI score in predicting major adverse cardiac events within 6 weeks, yielding a c-statistic of 0.87 compared to 0.61.
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