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Cardiac scoring systems, coronary artery disease and major adverse cardiovascular events: A scoping review
Preesha Premsagar1, Colleen Aldous, Tonya Esterhuizen
1Department of Internal Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban. preesha1@yahoo.com.
Insights
Cardiac scoring systems offer an objective approach for preventing coronary artery disease (CAD) and major adverse cardiovascular events (MACE). This review assesses their use in primary and secondary prevention strategies.
Area of Science:
- Cardiology
- Preventive Medicine
- Health Services Research
Background:
- Coronary artery disease (CAD) is the leading global cause of death.
- Major adverse cardiovascular events (MACE) pose a significant health burden.
- Early screening and intervention are crucial for managing CAD and MACE.
Purpose of the Study:
- To conduct a scoping review of the literature on cardiac scoring systems for predicting CAD and MACE.
- To assess the current evidence for the use of cardiac scoring systems in primary and secondary prevention.
Main Methods:
- A scoping review was performed using updated Arksey and O'Malley and PRISMA-ScR methodologies.
- Boolean searches were conducted on PubMed, ScienceDirect, MedLine, and Cochrane Library.
- Search terms included 'coronary artery disease', 'cardiac scoring systems', and 'major adverse cardiovascular events'.
Main Results:
- Nineteen English-language studies published after 2000 were included.
- Six studies lacked participants, focusing on guidelines and trials in progress.
- Thirteen studies from multinational clinical trials demonstrated the use of scoring systems for secondary prevention of CAD and MACE.
Conclusions:
- Cardiac scoring systems provide an objective method for both primary and secondary prevention of CAD and MACE.
- These systems can aid in managing clinical uncertainty and standardizing patient data for research.
Background:
In 2019, the World Health Organization (WHO) declared coronary artery disease (CAD) as the leading cause of death globally for the last 20 years. Early screening and detection (primary prevention) and intervention (secondary prevention) are necessary to curb CAD and major adverse cardiovascular event (MACE) prevalence. A scoping review to assess the current literature on using cardiac scoring systems to predict CAD and MACE was performed.
Methods:
The research question 'What is the literature on using cardiac scoring systems to predict CAD and MACE?' was addressed. The updated Arksey and O'Malley and the Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews methodologies were used. The search terms 'coronary artery disease' and 'cardiac scoring systems' and 'major adverse cardiovascular events' were used in the Boolean search on PubMed, ScienceDirect, MedLine and Cochrane Library.
Results:
The final list consisted of 19 published English results after the year 2000. There were six results without participants (four clinical guidelines, one review article and one ongoing clinical trial). Scoring systems were cardiovascular risk estimation systems focusing on the primary prevention of CAD; MACE was discussed but not scored. There were 13 robust results published from completed multinational clinical trials with participants. These results focused on a scoring system for the secondary prevention of CAD and MACE.
Conclusion:
Scoring systems remain an objective method for primary and secondary prevention of CAD and MACE.Contribution: Scoring systems may be helpful with clinical uncertainty or to standardise patient results for comparison in research.
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