Performance of the modified HEART score in an Asian population
| Autor: | Michael P. De Dios, Amila Clarence Punyadasa, Shanaz Matthew Sajeed, Dan Wei Jun Ong |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome Chest pain 03 medical and health sciences Geriatric cardiology 0302 clinical medicine Internal medicine medicine 030212 general & internal medicine cardiovascular diseases Angiology Original Research biology business.industry Emergency department lcsh:Medical emergencies. Critical care. Intensive care. First aid 030208 emergency & critical care medicine lcsh:RC86-88.9 medicine.disease Troponin Modified HEART score Conventional PCI Emergency Medicine biology.protein Major adverse cardiac event medicine.symptom business Mace |
| Zdroj: | International Journal of Emergency Medicine International Journal of Emergency Medicine, Vol 13, Iss 1, Pp 1-8 (2020) |
| ISSN: | 1865-1380 1865-1372 |
| Popis: | Introduction Chest pain is the most common potentially life-threatening presentation to the emergency department (ED). Furthermore, the identification of acute coronary syndrome (ACS) including its risk stratification and subsequent disposition can be challenging. The original HEART score was derived as a predictive tool to risk stratify patients presenting with undifferentiated chest pain (CP) and aid physician decision-making. However, it utilized conventional troponins as its cardiac biomarker component. Our study aims to assess the utility of the modified HEART score with highly sensitive troponins in an Asian setting with mixed ethnicity to determine if it corroborates the findings of another recent Chinese study by Chun-Peng et al. (Journal of Geriatric Cardiology 13:64–69, 2016). Methods Clinical data from 413 patients presenting to the ED for evaluation of chest pain were analyzed. The predictive value of the modified HEART score for determining major adverse cardiac events (MACE) was then evaluated. Results A total of 49 patients (11.9%) had a MACE: 31 patients (7.5%) underwent PCI and 1 patient (0.2%) underwent CABG. There were 17 (4.1%) deaths. Three risk groups were elucidated based on MACE. In the low-risk group (0–2), there were 72 patients (17.4%), with a MACE rate of 1.4%. In the intermediate-risk group (3–5), there were 233 patients (56.4%), with a MACE rate of 5.2%. In the high-risk group (6–10), there were 108 patients (26.2%), with a MACE rate of 33.3%. Conclusion The modified HEART score is an effective risk stratification tool in an ethnically diverse Asian population. Furthermore, it identifies low-risk patients who are candidates for early discharge from a local emergency department. |
| Databáze: | OpenAIRE |
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