HEART vs EDACS Scores on Predicting Major Events Among Patients With Suspected Acute Coronary Syndrome at the Cardiac
Shimaa Mohamed Hasballa1, Mohamed Aboel-Kassem F Abdelmegid, Mogedda Mohamed Mehany
1Author Affiliations: Heart Hospital, Msc, Faculty of Nursing, Assiut University, Assiut, Egypt (Mrs Hasballa); Department of Critical care & Emergency Nursing, Assiut University, Assiut, Egypt (Mrs Mehany); and Department of Cardiology, Faculty of Medicine, Assiut University, Assiut, Egypt (Mr Abdelmegid).
Insights
The HEART score is more sensitive than the EDACS score for identifying patients with acute coronary syndrome (ACS) who are at risk for major adverse cardiac events (MACE). Nurses can use the HEART score for quicker MACE risk assessment in the emergency department.
Area of Science:
- Cardiology
- Emergency Medicine
- Clinical Risk Assessment
Background:
- Nurses utilize coronary risk scores like HEART and EDACS to identify patients with suspected acute coronary syndrome (ACS) at risk for major adverse cardiac events (MACE).
- Accurate risk stratification is crucial in the cardiac emergency department (ED) for timely intervention and patient management.
Purpose of the Study:
- To compare the predictive accuracy of the History, Electrocardiogram, Age, Risk Factors, and Troponin (HEART) score and the Emergency Department Assessment of Chest Pain Score (EDACS) for MACE in patients with suspected ACS.
- To evaluate the utility of these scores in a cardiac ED setting.
Main Methods:
- A prospective observational study was conducted on patients presenting to a cardiac ED with suspected ACS.
- Data collected included patient assessments, HEART scores, EDACS scores, and 30-day MACE incidence.
- Statistical analysis compared the predictive performance of the two risk scores.
Main Results:
- The HEART score was significantly higher in patients who experienced MACE (P < .01), while the EDACS score showed no significant difference (P > .05).
- HEART score >6 demonstrated a sensitivity of 77.46% and specificity of 48.28% for predicting MACE.
- EDACS score >18 showed a sensitivity of 42.25% and specificity of 75.86% for predicting MACE.
Conclusions:
- The HEART score exhibits superior sensitivity compared to the EDACS score in predicting MACE among suspected ACS patients in the cardiac ED.
- The HEART score offers a faster and more reliable method for nurses to assess MACE risk upon patient arrival.
- Implementation of the HEART score in cardiac EDs is recommended, alongside nurse education, to improve MACE prediction and patient management.
Abstract:
Coronary risk scores, such as History, Electrocardiogram, Age, Risk Factors, and Troponin (HEART) and Emergency Department Assessment of Chest Pain Score (EDACS) scores, help nurses identify suspected acute coronary syndrome (ACS) patients who have a risk for major adverse cardiac events (MACE) within 30 days.
Aim:
To compare the accuracy of HEART and EDACS scores in predicting major events among patients suspected of ACS in the cardiac emergency department (ED).
Design And Methods:
A prospective correlational observational study design was performed on cardiac ED patients who presented with suspected ACS.
Tools:
Three tools were utilized to collect data pertinent to the study: Tool I comprises patients' assessment (personal characteristics, risk factors for ACS, and chest pain assessment sheet); Tool II is the risk assessment tool that includes HEART and EDACS scores; and Tool III is MACE incidence among studied patients within 30 days.
Results:
HEART score was significantly (P < .01) higher among patients for whom MACE was present than absent. However, EDACS score showed no significant difference (P > .05) among patients whose MACE was present or absent. HEART risk score >6 correctly predicted MACE cases with sensitivity and specificity of 77.46% and 48.28%, respectively. However, EDACS score >18 correctly predicted MACE cases with sensitivity and specificity of 42.25% and 75.86%, respectively.
Conclusion:
This study concludes that HEART score has better sensitivity than EDACS in predicting MACE among suspected ACS patients at the cardiac ED. The HEART score provides the nurses with a quicker and more reliable predictor of MACE shortly after the arrival of the suspected ACS patients at the cardiac ED than the EDACS score. The study recommended the implementation of a HEART score in the cardiac ED for predicting MACE in suspected ACS patients. Follow up closely for high-risk patients to MACE. An educational program should be made for nurses about the implementation of the heart score in the cardiac ED.
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