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Comparison of HEAR and HEART Scores for Major Adverse Cardiovascular Events
1Department of Cardiology, İzmir Ödemiş State Hospital, İzmir, TUR.
Insights
The HEART score demonstrated higher effectiveness than the HEAR score in identifying patients at high risk for major adverse cardiovascular events (MACE) within 30 days in the emergency department.
Area of Science:
- Cardiology
- Emergency Medicine
- Clinical Risk Stratification
Background:
- Effective risk stratification for acute coronary syndrome (ACS) in the emergency department (ED) is crucial for patient management and resource allocation.
- The HEAR and HEART scores are tools used to assess short-term risk of major adverse cardiovascular events (MACE).
Purpose of the Study:
- To compare the diagnostic accuracy of the HEAR score versus the HEART score for predicting 30-day MACE in patients presenting with chest pain.
- To evaluate the utility of these scores in optimizing emergency department workflows.
Main Methods:
- A prospective study involving 230 patients presenting to the ED with chest pain.
- Calculation of HEAR and HEART scores, with MACE defined as MI, revascularization, death, cardiac arrest, cardiogenic shock, or arrhythmias within 30 days.
- Receiver Operating Characteristic (ROC) analysis to determine optimal threshold values and compare sensitivity and specificity.
Main Results:
- Out of 230 patients, 56 (24.3%) experienced MACE.
- An optimal threshold of ≤3 for both scores yielded a sensitivity of 0.77 and specificity of 0.78 for the HEAR score.
- The HEART score achieved a sensitivity of 0.82 and specificity of 0.77 at the same threshold.
Conclusions:
- Both HEAR and HEART scoring systems are valuable tools for managing chest pain patients in the ED.
- The HEART score exhibited superior performance in predicting 30-day MACE compared to the HEAR score.
Background:
Early identification of patients with low and high risk for acute coronary syndrome in the emergency department (ED) is important for process management and proper resource use. The aim of this study was to compare the HEAR and HEART scores to determine the risk for major adverse cardiovascular events (MACE) over 30 days.
Methods:
Demographic data and clinical evaluations of the patients who presented to the ED with chest pain were recorded. ECGs were evaluated without knowing the clinical status of the patients. The HEART (including history, ECG, age, coronary risk factors, and troponin level) and HEAR (including four items with no troponin) risk scores were calculated. MACE was defined as all MI, all coronary revascularization procedures (PCI and CABG), all-cause death, cardiac arrest, cardiogenic shock, or life-threatening cardiac arrhythmias within 30 days. Patients with MACE were evaluated as Group 1, and patients without MACE were considered as Group 2, and the data from the two groups were compared.
Results:
A total of 230 patients were included in the study. There were 56 (24.3%) patients with MACEs. According to the ROC analysis, the threshold value was determined as ≤3 for both scoring systems. According to this threshold value, sensitivity and specificity were found to be 0.77 and 0.78 for the HEAR score and 0.82 and 0.77 for the HEART score.
Conclusions:
Although the HEAR and HEART scoring systems are useful for the management of patients with chest pain in the ED, the HEART score was evaluated to be more effective.
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