The Role of HEART Score in Predicting Major Adverse Cardiac Events in Patients with Possible Acute Coronary Syndrome Presenting to the Emergency Department

Cardiovascular Journal Pub Date : 2023-10-02 DOI:10.3329/cardio.v16i1.68060

Fahdia Afroz, Mohammad Ullah, Shah Golam Nabi, Md Ruhul Amin Tuhin, Md Mahbubur Rahman, Md Abdullah, Md Saiful Islam, Md Minhaj Arefin

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Abstract

Introduction: Acute coronary syndrome is very challenging & sometimes very confusing to diagnose. The HEART score was designed to be a prognostic prediction model, using information from the patient’s history, ECG, age, risk factors, and troponin level at the initial emergency department. This study was conducted to assess the role of HEART score in predicting major adverse cardiac events in patients with possible acute coronary syndrome presenting to the emergency department. Methods: This prospective observational study was conducted among 453 patients presented with acute coronary syndrome (ACS) at the Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh from January 2023 to June 2023 to assess the role of HEART score in predicting major adverse cardiac events (MACE) in patients with possible acute coronary syndrome. The study population was divided into two groups depending on HEART score. MACE was observed between these two groups. Results: Mean age of the respondents was 53.45±11.23 years where 77.7% of them were male. 55% had smoking habit, 36% had history of Diabetes Mellitus, and 38% had history of HTN. Among the respondents 62.9 % was improved. 11.03 % respondents developed heart failure, 14.34% recurrent ischemic pain, 7.9% of recurrent MI, 2.8 % cardiogenic shock, and 0.88 % cases of death. HEART score as predictor was statistically significant (X2=69.7, df=1, p<0.05), indicated to distinguish between major adverse cardiac events and no major cardiac events. Conclusion: Almost one third of respondents with high HEART score had heart failure and recurrent ischemic pain. There was statistically significant difference in incidence of major adverse cardiac events between high and low HEART score groups. The HEART score can be used to predict risk for major adverse cardiac events effectively in patients with suspected ACS. This can help us to determine needs for urgent treatment and hospitalization among the patients who present with suspected ACS. Cardiovasc j 2023; 16(1): 9-16

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HEART评分在预测急诊可能出现急性冠状动脉综合征患者主要心脏不良事件中的作用

简介:急性冠脉综合征是非常具有挑战性的&有时很难诊断。HEART评分被设计成一个预后预测模型，使用患者的病史、心电图、年龄、危险因素和初始急诊科的肌钙蛋白水平。本研究旨在评估HEART评分在预测急诊可能出现急性冠状动脉综合征患者的主要心脏不良事件中的作用。方法:这项前瞻性观察性研究于2023年1月至2023年6月在孟加拉国达卡国家心血管疾病研究所心内科进行，共纳入453例急性冠脉综合征(ACS)患者，以评估HEART评分在预测可能的急性冠脉综合征患者的主要不良心脏事件(MACE)中的作用。根据心脏评分将研究人群分为两组。两组间观察MACE。结果:调查对象平均年龄为53.45±11.23岁，男性占77.7%。有吸烟习惯的占55%，有糖尿病史的占36%，有HTN史的占38%。62.9%的应答者得到了改善。11.03%的受访者发生心力衰竭，14.34%复发性缺血性疼痛，7.9%复发性心肌梗死，2.8%心源性休克，0.88%死亡。HEART评分作为预测因子有统计学意义(X2=69.7, df=1, p<0.05)，表明可以区分严重心脏不良事件与无严重心脏不良事件。结论:近三分之一的受访患者有心力衰竭和复发性缺血性疼痛。主要心脏不良事件的发生率在心脏评分高组和低组之间有统计学差异。HEART评分可有效预测疑似ACS患者发生主要心脏不良事件的风险。这可以帮助我们确定疑似ACS患者是否需要紧急治疗和住院治疗。心血管病[j] 2023;16(1): 9到16

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Cardiovascular Journal

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