SVEAT score outperforms HEART score in patients admitted to a chest pain observation unit.

Autor:	Antwi-Amoabeng D; Department of Internal Medicine, Reno School of Medicine, University of Nevada, Reno, NV 89502, United States., Roongsritong C; Institute for Heart and Vascular Health, Renown Regional Medical Center, Reno, NV 89502, United States., Taha M; Department of Internal Medicine, Reno School of Medicine, University of Nevada, Reno, NV 89502, United States., Beutler BD; Department of Internal Medicine, Reno School of Medicine, University of Nevada, Reno, NV 89502, United States. brycebeutler@hotmail.com., Awad M; Department of Internal Medicine, Reno School of Medicine, University of Nevada, Reno, NV 89502, United States., Hanfy A; Department of Internal Medicine, Reno School of Medicine, University of Nevada, Reno, NV 89502, United States., Ghuman J; Department of Internal Medicine, Reno School of Medicine, University of Nevada, Reno, NV 89502, United States., Manasewitsch NT; Department of Internal Medicine, Reno School of Medicine, University of Nevada, Reno, NV 89502, United States., Singh S; Department of Internal Medicine, Reno School of Medicine, University of Nevada, Reno, NV 89502, United States., Quang C; Department of Internal Medicine, Reno School of Medicine, University of Nevada, Reno, NV 89502, United States., Gullapalli N; Department of Internal Medicine, Reno School of Medicine, University of Nevada, Reno, NV 89502, United States.
Jazyk:	angličtina
Zdroj:	World journal of cardiology [World J Cardiol] 2022 Aug 26; Vol. 14 (8), pp. 454-461.
DOI:	10.4330/wjc.v14.i8.454
Abstrakt:	Background: Timely and accurate identification of subgroup at risk for major adverse cardiovascular events among patients presenting with acute chest pain remains a challenge. Currently available risk stratification scores are suboptimal. Recently, a new scoring system called the Symptoms, history of Vascular disease, Electrocardiography, Age, and Troponin (SVEAT) score has been shown to outperform the History, Electrocardiography, Age, Risk factors and Troponin (HEART) score, one of the most used risk scores in the United States. Aim: To assess the potential usefulness of the SVEAT score as a risk stratification tool by comparing its performance to HEART score in chest pain patients with low suspicion for acute coronary syndrome and admitted for overnight observation. Methods: We retrospectively reviewed medical records of 330 consecutive patients admitted to our clinical decision unit for acute chest pain between January 1 st to April 17 th , 2019. To avoid potential biases, investigators assigned to calculate the SVEAT, and HEART scores were blinded to the results of 30-d combined endpoint of death, acute myocardial infarction or confirmed coronary artery disease requiring revascularization or medical therapy [30-d major adverse cardiovascular event (MACE)]. An area under receiving-operator characteristic curve (AUC) for each score was then calculated. C-statistic and logistic model were used to compare predictive performance of the two scores. Results: A 30-d MACE was observed in 11 patients (3.33% of the subjects). The AUC of SVEAT score (0.8876, 95%CI: 0.82-0.96) was significantly higher than the AUC of HEART score (0.7962, 95%CI: 0.71-0.88), P = 0.03. Using logistic model, SVEAT score with cut-off of 4 or less significantly predicts 30-d MACE (odd ratio 1.52, 95%CI: 1.19-1.95, P = 0.001) but not the HEART score (odd ratio 1.29, 95%CI: 0.78-2.14, P = 0.32). Conclusion: The SVEAT score is superior to the HEART score as a risk stratification tool for acute chest pain in low to intermediate risk patients. Competing Interests: Conflict-of-interest statement: The authors declare no actual or potential conflicts of interest or relationship with industry. (©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.)
Databáze:	MEDLINE
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