Document Detail


Chest pain in the emergency room: a multicenter validation of the HEART Score.
MedLine Citation:
PMID:  20802272     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Decision-making in chest pain patients is hampered by poor diagnostic power of patient's history, electrocardiogram, age, risk factors, and troponin. Each of these findings may be qualified with 0, 1, or 2 points. Together they compose the HEART score. We tested the hypothesis that the HEART score predicts major adverse cardiac events.
DESIGN: Retrospective multicenter analysis in patients presenting at the cardiology emergency room.
SETTING: Patient inclusion between January 1 and March 31, 2006.
PATIENTS: A total of 2161 patients were admitted, of which 910 patients (42%) presented with chest pain. Analysis was performed in 880 cases (96.7%).
MAIN OUTCOME MEASURES: The primary endpoint was a composite of acute myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft surgery and death, within 6 weeks after presentation, together called major adverse cardiac events.
RESULTS: A total of 158 patients (17.95%) reached the primary endpoint. Ninety-two patients had an acute myocardial infarction (10.45%), 82 a percutaneous coronary intervention (9.32%), 36 a coronary artery bypass graft (4.09%), and 13 died (1.48%). Of 303 patients with HEART score 0 to 3, three (0.99%) had an endpoint. In 413 patients with HEART score 4 to 6, 48 cases (11.6%) reached an endpoint. In case of a HEART score of 7 to 10, an endpoint was reached in 107/164 cases (65.2%).
CONCLUSIONS: The HEART score helps in making accurate diagnostic and therapeutic decisions without the use of radiation or invasive procedures. The HEART score is an easy, quick, and reliable predictor of outcome in chest pain patients and can be used for triage.
Authors:
Barbra E Backus; A Jacob Six; Johannes C Kelder; Thomas P Mast; Frederieke van den Akker; E Gijis Mast; Stefan H J Monnink; Rob M van Tooren; Pieter A F M Doevendans
Publication Detail:
Type:  Journal Article; Multicenter Study; Validation Studies    
Journal Detail:
Title:  Critical pathways in cardiology     Volume:  9     ISSN:  1535-2811     ISO Abbreviation:  Crit Pathw Cardiol     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-30     Completed Date:  2010-12-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101165286     Medline TA:  Crit Pathw Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  164-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Universitair Medisch Centrum, Utrecht, Nieuwegein, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Angioplasty, Balloon, Coronary / methods
Biological Markers / blood
Chest Pain / diagnosis*,  mortality,  therapy
Cohort Studies
Coronary Angiography / methods
Coronary Artery Bypass / methods
Diagnostic Techniques, Cardiovascular / standards*
Early Diagnosis
Electrocardiography
Emergency Service, Hospital / utilization*
Female
Humans
Kaplan-Meier Estimate
Male
Myocardial Infarction / diagnosis*,  mortality,  therapy
Prognosis
Retrospective Studies
Risk Assessment
Severity of Illness Index
Survival Analysis
Troponin T / blood*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin T

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