Title of article :
HEART Score in PredictingOne-MonthMajor Adverse Cardiac Events in Patients with Acute Chest Pain; aDiagnostic Accuracy Study
Author/Authors :
Alimohammadi, Hossein Emergency Department - Imam Hossein Hospital - Faculty of Medicine - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Shojaee, Majid Emergency Department - Imam Hossein Hospital - Faculty of Medicine - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Sohrabi, Mohammad Reza Faculty of Medicine - Shahid Beheshti University of Medical Sciences, Tehran, Iran , Salahi, Saman Emergency Department - Imam Hossein Hospital - Faculty of Medicine - Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract :
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
MACEwas high in 34 (14.2%),moderate in 118 (49.2%), and lowin 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-monthMACE in ACS patients was in moderate range.
Keywords :
Chest pain , heart diseases , Heart Disease Risk Factors , Acute Coronary Syndrome , Emergency Service , Hospital
Journal title :
Archives of Academic Emergency Medicine (AAEM)
