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HEART-score can be ...
HEART-score can be simplified without loss of discriminatory power in patients with chest pain : Introducing the HET-score
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- Löfmark, Henrik (author)
- Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Stockholm, Sweden.;Karolinska Inst, Danderyds Univ Hosp, Dept Clin Sci, Dept Cardiol, S-18288 Stockholm, Sweden.
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- Muhrbeck, Josephine (author)
- Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Stockholm, Sweden.
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- Eggers, Kai M., 1962- (author)
- Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi
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- Linder, Rickard (author)
- Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Stockholm, Sweden.
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- Ljung, Lina (author)
- Karolinska Inst, Dept Clin Sci, Sodersjukhuset, Stockholm, Sweden.
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- Martinsson, Arne (author)
- Capio St Gorans Hosp, Stockholm, Sweden.
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- Melki, Dina (author)
- Ersta Hosp, Dept Med, Stockholm, Sweden.
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- Sarkar, Nondita (author)
- Karolinska Institutet
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- Svensson, Per (author)
- Karolinska Institutet
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- Lindahl, Bertil, 1957- (author)
- Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
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- Jernberg, Tomas (author)
- Karolinska Institutet
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Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Stockholm, Sweden;Karolinska Inst, Danderyds Univ Hosp, Dept Clin Sci, Dept Cardiol, S-18288 Stockholm, Sweden. Karolinska Inst, Danderyd Univ Hosp, Dept Clin Sci, Stockholm, Sweden. (creator_code:org_t)
- Elsevier, 2023
- 2023
- English.
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In: American Journal of Emergency Medicine. - : Elsevier. - 0735-6757 .- 1532-8171. ; 74, s. 104-111
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Abstract
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- BackgroundThe History, Electrocardiogram (ECG), Age, Risk factors and Troponin, (HEART) score is useful for early risk stratification in chest pain patients. The aim was to validate previous findings that a simplified score using history, ECG and troponin (HET-score) has similar ability to stratify risk.MethodsPatients presenting with chest pain with duration of ≥10 min and an onset of last episode ≤12 h but without ST-segment elevation on ECG at 6 emergency departments were eligible for inclusion. The HEART-score and the simplified HET-score were calculated. The endpoint was a composite of myocardial infarction (MI) as index diagnosis, readmission due to new MI or death within 30 days.ResultsHEART-score identified 32% as low risk (0-2p), 47% as intermediate risk (3-5p), and 20% as high risk (6-10p) patients. The endpoint occurred in 0.5%, 7.3% and 35.7%, respectively. HET-score identified 39%, 42% and 19% as low- (0p), intermediate- (1-2p) and high-risk (3-6p) patients, with the endpoint occurring in 0.6%, 6.2% and 43.2%, respectively.When all variables included in the HEART-score were included in a multivariable logistic regression analysis, only History (OR, CI [95%]): 2.97(2.16–4.09), ECG (1.61[1.14–2.28]) and troponin level (5.21[3.91–6.95]) were significantly associated with cardiovascular events. When HEART- and HET-score were compared in a ROC-analysis, HET-score had a significantly larger AUC (0.887 vs 0.853, p < 0.001).ConclusionsCompared with HEART-score, HET-score is simpler and appears to have similar ability to discriminate between chest pain patients with and without cardiovascular event.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Chest pain
- Acute coronary syndrome
- Score
- Diagnosis
- Prognosis
Publication and Content Type
- ref (subject category)
- art (subject category)
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- By the author/editor
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Löfmark, Henrik
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Muhrbeck, Joseph ...
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Eggers, Kai M., ...
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Linder, Rickard
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Ljung, Lina
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Martinsson, Arne
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show more...
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Melki, Dina
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Sarkar, Nondita
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Svensson, Per
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Lindahl, Bertil, ...
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Jernberg, Tomas
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- About the subject
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- MEDICAL AND HEALTH SCIENCES
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MEDICAL AND HEAL ...
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and Clinical Medicin ...
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and Cardiac and Card ...
- Articles in the publication
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American Journal ...
- By the university
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Uppsala University
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Karolinska Institutet