Study on application of the HEART score in stratifying risk among patients with chest pain in the Emergency and Stroke Center of Hue University of Medicine and Pharmacy Hospital

Abstract

Background: Chest pain is one of the most common reasons to attend the emergency department, accounting for approximately 10% of non-injury-related visits. Coronary artery disease is an important cause of chest pain that should be evaluated and managed early. The HEART score is designed to stratify the risk of emergency patients with undifferentiated chest pain, to identify high-risk patients who require more resources or need early emergency treatment, and low-risk patients to avoid unnecessary hospitalization. In my country, there have not been many studies on the HEART score yet. Objective: To evaluate the value of the HEART sore in risk stratification among patients with chest pain in the emergency department. Methods: Data used from 70 patients presented with chest pain to Emergency-Stroke Center of Hue university hospital. The HEART score was calculated. Outcome was occurrence of MACE (mortality, AMI, PCI, CABG) within 30-days of initial presentation. Results: Patient demographics include an average age of 63.80, 67.10% female, and 41.40% with history of hypertension, 21.40% with history PCI. 14.30% of patients met the outcome. The percent of patients with 30-day MACE with HEART score between 0 and 3, 4 - 6, and 7 - 10 was 4.30%, 10.50%, and 55.60%, respectively. With the cut-off of ≥ 4 points, the HEART score had prognostic value for the events in the study group with a sensitivity of 90%, a specificity of 63.3%, the area under the ROC curve was 0.86 (95% CI 0.71 - 1.00). Conclusion: The HEART score was valuable in risk stratification patients with chest pain in emergency department. Key words: HEART score, chest pain, emergency department.