Performance of the modified HEART score in an Asian population

International Journal of Emergency Medicine

article

Sajeed, Shanaz Matthew¹  De Dios, Michael P.²  Ong, Dan Wei Jun³  Punyadasa, Amila Clarence¹ 

[1] Department of Emergency Medicine and Department of Intensive Care Medicine, Ng Teng Fong General Hospital;Department of Emergency Medicine, Ng Teng Fong General Hospital;Department of Respiratory Therapy, Ng Teng Fong General Hospital

关键词: Chest pain;    Acute coronary syndrome;    Emergency department;    Major adverse cardiac event;    Modified HEART score;   

DOI  :  10.1186/s12245-020-00300-1

学科分类：工业工程学

来源: Springer

【 摘 要 】

Chest pain is the most common potentially life-threatening presentation to the emergency department (ED). Furthermore, the identification of acute coronary syndrome (ACS) including its risk stratification and subsequent disposition can be challenging. The original HEART score was derived as a predictive tool to risk stratify patients presenting with undifferentiated chest pain (CP) and aid physician decision-making. However, it utilized conventional troponins as its cardiac biomarker component. Our study aims to assess the utility of the modified HEART score with highly sensitive troponins in an Asian setting with mixed ethnicity to determine if it corroborates the findings of another recent Chinese study by Chun-Peng et al. (Journal of Geriatric Cardiology 13:64–69, 2016). Clinical data from 413 patients presenting to the ED for evaluation of chest pain were analyzed. The predictive value of the modified HEART score for determining major adverse cardiac events (MACE) was then evaluated. A total of 49 patients (11.9%) had a MACE: 31 patients (7.5%) underwent PCI and 1 patient (0.2%) underwent CABG. There were 17 (4.1%) deaths. Three risk groups were elucidated based on MACE. In the low-risk group (0–2), there were 72 patients (17.4%), with a MACE rate of 1.4%. In the intermediate-risk group (3–5), there were 233 patients (56.4%), with a MACE rate of 5.2%. In the high-risk group (6–10), there were 108 patients (26.2%), with a MACE rate of 33.3%. The modified HEART score is an effective risk stratification tool in an ethnically diverse Asian population. Furthermore, it identifies low-risk patients who are candidates for early discharge from a local emergency department.

【 授权许可】

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