The predictive value of HEART score for acute coronary syndrome and significant coronary artery stenosis
Objective Rapid determination of acute coronary syndrome (ACS) in the emergency department (ED) is very important for patients presenting with ischemic symptoms. The aim of this study was to determine the predictive value of HEART score for ACS and significant coronary artery stenosis (SCS). Methods...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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The Korean Society of Emergency Medicine
2020-12-01
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| Series: | Clinical and Experimental Emergency Medicine |
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| Online Access: | http://ceemjournal.org/upload/pdf/ceem-19-084.pdf |
| _version_ | 1797897186161197056 |
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| author | Changsung Han Heajin Chung Youngjoo Lee Hye Young Jang Young Shin Cho Junbum Park Sang-Il Kim |
| author_facet | Changsung Han Heajin Chung Youngjoo Lee Hye Young Jang Young Shin Cho Junbum Park Sang-Il Kim |
| author_sort | Changsung Han |
| collection | DOAJ |
| description | Objective Rapid determination of acute coronary syndrome (ACS) in the emergency department (ED) is very important for patients presenting with ischemic symptoms. The aim of this study was to determine the predictive value of HEART score for ACS and significant coronary artery stenosis (SCS). Methods We retrospectively analyzed data of patients who visited the ED with chest discomfort and were admitted to the cardiology department. Enrolled patients were classified into ACS and non-ACS groups according to their discharge diagnosis. Patients who underwent imaging were further divided into SCS and non-SCS groups according to study results. We compared age, sex, vital signs, risk factors, electrocardiogram, troponin, and HEART score for each group. For ACS and SCS predictive performance, the test characteristics of HEART score was calculated using sensitivity, specificity, predictive value, likelihood ratio, and receiver operating characteristic (ROC) curve analysis. Results Of 207 patients, 112 had ACS. Among enrolled patients, 155 underwent imaging workup, of whom 67 had SCS. HEART score ≤3 had 93% sensitivity for ACS and 97% for SCS. HEART score ≥7 had 82% specificity for ACS and 83% for SCS. HEART score area under ROC curve for ACS was 0.706 (95% confidence interval, 0.627–0.776) and 0.737 (95% confidence interval, 0.660–0.804) for SCS. Conclusion HEART score was a fair predictor of ACS and SCS in ED patients who presented with chest symptoms and were admitted to the cardiology department. The predictive power of HEART score was better for SCS than for ACS. |
| first_indexed | 2024-04-10T07:54:40Z |
| format | Article |
| id | doaj.art-d4f299c3f1ea4fcaaee5b4fdff4d6e60 |
| institution | Directory Open Access Journal |
| issn | 2383-4625 |
| language | English |
| last_indexed | 2024-04-10T07:54:40Z |
| publishDate | 2020-12-01 |
| publisher | The Korean Society of Emergency Medicine |
| record_format | Article |
| series | Clinical and Experimental Emergency Medicine |
| spelling | doaj.art-d4f299c3f1ea4fcaaee5b4fdff4d6e602023-02-23T06:58:13ZengThe Korean Society of Emergency MedicineClinical and Experimental Emergency Medicine2383-46252020-12-017426727410.15441/ceem.19.084309The predictive value of HEART score for acute coronary syndrome and significant coronary artery stenosisChangsung Han0Heajin ChungYoungjoo Lee1Hye Young Jang2Young Shin Cho3Junbum Park4Sang-Il Kim5 Department of Emergency Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea Department of Emergency Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea Department of Emergency Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea Department of Emergency Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea Department of Emergency Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea Department of Emergency Medicine, Soonchunhyang University Seoul Hospital, Seoul, KoreaObjective Rapid determination of acute coronary syndrome (ACS) in the emergency department (ED) is very important for patients presenting with ischemic symptoms. The aim of this study was to determine the predictive value of HEART score for ACS and significant coronary artery stenosis (SCS). Methods We retrospectively analyzed data of patients who visited the ED with chest discomfort and were admitted to the cardiology department. Enrolled patients were classified into ACS and non-ACS groups according to their discharge diagnosis. Patients who underwent imaging were further divided into SCS and non-SCS groups according to study results. We compared age, sex, vital signs, risk factors, electrocardiogram, troponin, and HEART score for each group. For ACS and SCS predictive performance, the test characteristics of HEART score was calculated using sensitivity, specificity, predictive value, likelihood ratio, and receiver operating characteristic (ROC) curve analysis. Results Of 207 patients, 112 had ACS. Among enrolled patients, 155 underwent imaging workup, of whom 67 had SCS. HEART score ≤3 had 93% sensitivity for ACS and 97% for SCS. HEART score ≥7 had 82% specificity for ACS and 83% for SCS. HEART score area under ROC curve for ACS was 0.706 (95% confidence interval, 0.627–0.776) and 0.737 (95% confidence interval, 0.660–0.804) for SCS. Conclusion HEART score was a fair predictor of ACS and SCS in ED patients who presented with chest symptoms and were admitted to the cardiology department. The predictive power of HEART score was better for SCS than for ACS.http://ceemjournal.org/upload/pdf/ceem-19-084.pdfchest painacute coronary syndromecoronary stenosisdiagnosis |
| spellingShingle | Changsung Han Heajin Chung Youngjoo Lee Hye Young Jang Young Shin Cho Junbum Park Sang-Il Kim The predictive value of HEART score for acute coronary syndrome and significant coronary artery stenosis Clinical and Experimental Emergency Medicine chest pain acute coronary syndrome coronary stenosis diagnosis |
| title | The predictive value of HEART score for acute coronary syndrome and significant coronary artery stenosis |
| title_full | The predictive value of HEART score for acute coronary syndrome and significant coronary artery stenosis |
| title_fullStr | The predictive value of HEART score for acute coronary syndrome and significant coronary artery stenosis |
| title_full_unstemmed | The predictive value of HEART score for acute coronary syndrome and significant coronary artery stenosis |
| title_short | The predictive value of HEART score for acute coronary syndrome and significant coronary artery stenosis |
| title_sort | predictive value of heart score for acute coronary syndrome and significant coronary artery stenosis |
| topic | chest pain acute coronary syndrome coronary stenosis diagnosis |
| url | http://ceemjournal.org/upload/pdf/ceem-19-084.pdf |
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