Related Experiment Video

Updated: Mar 21, 2026

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
06:16

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

1.0K

Prognostic Factors in Chest Pain Patients: A Quantitative Analysis of the HEART Score

Barbra E Backus1, A Jacob Six, Pieter A Doevendans

  • 1From the *Department of Emergency Medicine, Medisch Centrum Haaglanden, The Hague, The Netherlands; †Department of Cardiology, Hofpoort hospital Woerden, Woerden, The Netherlands; ‡Department of Cardiology, University Medical Centre, Utrecht, The Netherlands; §Department of Research and Development, St Antonius Hospital, Nieuwegein, The Netherlands; and ¶Department of Public Health, Erasmus Medical Centre, Rotterdam, The Netherlands.

Critical Pathways in Cardiology
|May 17, 2016
PubMed

Insights

The HEART score effectively predicts major adverse cardiac events in chest pain patients. While an adjusted HEART score offers minor improvements, the original HEART score remains clinically useful for risk stratification in emergency departments.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Clinical Risk Assessment

Background:

  • Risk stratification for emergency department chest pain patients is crucial.
  • The HEART score (History, ECG, Age, Risk Factors, Troponin) estimates major adverse cardiac event (MACE) risk.
  • Current guidelines recommend risk stratification for chest pain patients.

Purpose of the Study:

  • To evaluate the predictive impact of individual HEART score components.
  • To compare the performance of the original HEART score against a regression-based adjusted model.
  • To validate the HEART score's components and overall performance.

Main Methods:

  • Prospective data analysis of 2388 chest pain patients.
  • Calculation of the original HEART score and a multivariable logistic regression-adjusted HEART score (HEART-adj).
  • Assessment of calibration, discrimination (c-statistic), decision curve analysis, and net reclassification improvement.

Main Results:

  • Univariate analysis confirmed the predictive order of HEART components.
  • The adjusted HEART score showed slightly improved calibration and discrimination (c-statistic 0.85 vs. 0.83).
  • The original HEART score demonstrated better patient classification (net reclassification improvement 14.1%) despite minor gains with HEART-adj.

Conclusions:

  • Multivariable analyses support the established weights of the HEART score components.
  • Minor improvements in calibration and discrimination are achievable with score adaptation.
  • Both original and adjusted HEART scores are clinically valuable for daily practice in managing chest pain patients.
Abstract

More Related Videos

Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty10:03

Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty

Published on: January 28, 2020

5.9K
Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery06:46

Competing-Risk Nomogram for Predicting Cancer-Specific Survival in Multiple Primary Colorectal Cancer Patients after Surgery

Published on: September 27, 2024

998

Related Concept Videos

Angina III: Clinical Manifestations and Assessment01:29

Angina III: Clinical Manifestations and Assessment

Angina manifests as chest pain, tightness, or squeezing discomfort typically located behind the breastbone. It can radiate to the neck, jaw, shoulders, and inner aspects of the upper arms, most commonly the left arm. Patients may experience shortness of breath, fatigue, profuse sweating, dizziness, indigestion, heartburn, palpitations, anxiety, and vomiting as accompanying symptoms. This pain often lasts a few minutes and is triggered by physical exertion, emotional stress, heavy meals, or cold...
353
Angina V: Nursing Management01:20

Angina V: Nursing Management

Angina, a symptom of myocardial ischemia, requires a structured nursing management approach to ensure effective care and prevent complications like myocardial infarction. Comprehensive nursing care involves assessing, diagnosing, planning, implementing interventions, and evaluating outcomes, all tailored to the individual patient's needs.Patient AssessmentNursing assessment begins with a detailed subjective evaluation of symptoms, which typically include chest pain or pressure radiating to the...
502
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
407
Pericarditis II: Clinical Features and Diagnostic Tests01:19

Pericarditis II: Clinical Features and Diagnostic Tests

Pericarditis is distinguished by inflammation of the pericardium, the fibrous sac that encases the heart. It can be acute, lasting less than six weeks, or chronic, persisting for over three months. Understanding its clinical manifestations and diagnostic findings is crucial for timely and effective management.Clinical ManifestationsWhile pericarditis can be asymptomatic, it usually presents with characteristic symptoms such as:Chest Pain: The most characteristic symptom of pericarditis is chest...
505
Angina II: Classification01:27

Angina II: Classification

Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
557
Angina I: Introduction01:30

Angina I: Introduction

Definition and Symptoms: Angina (angina pectoris) is chest pain or discomfort caused by myocardial ischemia, which occurs when the heart muscle receives insufficient oxygen-rich blood. It typically manifests as pressing, squeezing, or crushing sensations in the chest and may radiate to the shoulders, arms, neck, jaw, or back.Primary Cause: In a healthy state, the coronary arteries can dilate (widen) to increase blood flow and meet the increased oxygen demand during physical activity or...
665