HEART Score as a Predictor of Angiographic Severity of Coronary Artery Disease in Patients Diagnosed with Acute Coronary Syndrome

Background: Acute coronary syndrome (ACS) is a major cause of morbidity and mortality worldwide.Rapid risk stratification of patients presenting with chest pain is essential for early diagnosis and appropriate management.The HEART score, which incorporates History, Electrocardiogram, Age, Risk factors, and Troponin levels, has emerged as a simple and effective clinical tool for predicting major adverse cardiac events.However, limited studies have evaluated its relationship with the angiographic severity of coronary artery disease (CAD), particularly in the Indian population.Objective: To assess the HEART score in patients with acute coronary syndrome and to evaluate its correlation with the angiographic severity of coronary artery disease.Methods: This prospective observational study was conducted in the Department of General Medicine at a tertiary care teaching hospital.A total of 50 adult patients diagnosed with acute coronary syndrome were included.Clinical history, cardiovascular risk factors, electrocardiographic findings, and troponin levels were recorded, and the HEART score was calculated for each patient.Patients were categorized into low-risk (0-3), moderate-risk (4-6), and high-risk (7-10) groups.All patients underwent coronary angiography to determine the severity of coronary artery disease.Statistical analysis was performed using SPSS software, and the association between HEART score categories and angiographic findings was analyzed using the Chi-square test, with p < 0.05 considered statistically significant.Results: The mean age of the study population was 56.8 ± 11.4 years, and 68% of the patients were male.Hypertension (60%) and diabetes mellitus (52%) were the most common cardiovascular risk factors.Based on the HEART score classification, 18% of patients were categorized as low risk, 52% as moderate risk, and 30% as high risk.Coronary angiography revealed single vessel disease in 36% of patients, double vessel disease in 26%, triple vessel disease in 20%, and normal coronary arteries in 18%.A significant association was observed between increasing HEART score categories and the severity of coronary artery disease (χ² = 12.84, p = 0.002), with multi-vessel disease predominantly observed in patients with higher HEART scores. Conclusion:The HEART score is a simple and effective bedside risk stratification tool that correlates significantly with the angiographic severity of coronary artery disease in patients with acute coronary syndrome.Its routine use in clinical practice may help identify high-risk patients early and facilitate timely diagnostic and therapeutic interventions.