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Validation and modification of HEART score components for patients with chest pain in the emergency department

OBJECTIVE: This study aimed to clarify the relative prognostic value of each History, Electrocardiography, Age, Risk Factors, and Troponin (HEART) score component for major adverse cardiac events (MACE) within 3 months and validate the modified HEART (mHEART) score. METHODS: This study evaluated the...

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Autores principales: Kim, Min Jae, Ha, Sang Ook, Park, Young Sun, Yi, Jeong Hyeon, Yang, Won Seok, Kim, Jin Hyuck
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Korean Society of Emergency Medicine 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8743685/
https://www.ncbi.nlm.nih.gov/pubmed/35000355
http://dx.doi.org/10.15441/ceem.20.106
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author Kim, Min Jae
Ha, Sang Ook
Park, Young Sun
Yi, Jeong Hyeon
Yang, Won Seok
Kim, Jin Hyuck
author_facet Kim, Min Jae
Ha, Sang Ook
Park, Young Sun
Yi, Jeong Hyeon
Yang, Won Seok
Kim, Jin Hyuck
author_sort Kim, Min Jae
collection PubMed
description OBJECTIVE: This study aimed to clarify the relative prognostic value of each History, Electrocardiography, Age, Risk Factors, and Troponin (HEART) score component for major adverse cardiac events (MACE) within 3 months and validate the modified HEART (mHEART) score. METHODS: This study evaluated the HEART score components for patients with chest symptoms visiting the emergency department from November 19, 2018 to November 19, 2019. All components were evaluated using logistic regression analysis and the scores for HEART, mHEART, and Thrombolysis in Myocardial Infarction (TIMI) were determined using the receiver operating characteristics curve. RESULTS: The patients were divided into a derivation (809 patients) and a validation group (298 patients). In multivariate analysis, age did not show statistical significance in the detection of MACE within 3 months and the mHEART score was calculated after omitting the age component. The areas under the receiver operating characteristics curves for HEART, mHEART and TIMI scores in the prediction of MACE within 3 months were 0.88, 0.91, and 0.83, respectively, in the derivation group; and 0.88, 0.91, and 0.81, respectively, in the validation group. When the cutoff value for each scoring system was determined for the maintenance of a negative predictive value for a MACE rate >99%, the mHEART score showed the highest sensitivity, specificity, positive predictive value, and negative predictive value (97.4%, 54.2%, 23.7%, and 99.3%, respectively). CONCLUSION: Our study showed that the mHEART score better detects short-term MACE in high-risk patients and ensures the safe disposition of low-risk patients than the HEART and TIMI scores.
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spelling pubmed-87436852022-01-14 Validation and modification of HEART score components for patients with chest pain in the emergency department Kim, Min Jae Ha, Sang Ook Park, Young Sun Yi, Jeong Hyeon Yang, Won Seok Kim, Jin Hyuck Clin Exp Emerg Med Original Article OBJECTIVE: This study aimed to clarify the relative prognostic value of each History, Electrocardiography, Age, Risk Factors, and Troponin (HEART) score component for major adverse cardiac events (MACE) within 3 months and validate the modified HEART (mHEART) score. METHODS: This study evaluated the HEART score components for patients with chest symptoms visiting the emergency department from November 19, 2018 to November 19, 2019. All components were evaluated using logistic regression analysis and the scores for HEART, mHEART, and Thrombolysis in Myocardial Infarction (TIMI) were determined using the receiver operating characteristics curve. RESULTS: The patients were divided into a derivation (809 patients) and a validation group (298 patients). In multivariate analysis, age did not show statistical significance in the detection of MACE within 3 months and the mHEART score was calculated after omitting the age component. The areas under the receiver operating characteristics curves for HEART, mHEART and TIMI scores in the prediction of MACE within 3 months were 0.88, 0.91, and 0.83, respectively, in the derivation group; and 0.88, 0.91, and 0.81, respectively, in the validation group. When the cutoff value for each scoring system was determined for the maintenance of a negative predictive value for a MACE rate >99%, the mHEART score showed the highest sensitivity, specificity, positive predictive value, and negative predictive value (97.4%, 54.2%, 23.7%, and 99.3%, respectively). CONCLUSION: Our study showed that the mHEART score better detects short-term MACE in high-risk patients and ensures the safe disposition of low-risk patients than the HEART and TIMI scores. The Korean Society of Emergency Medicine 2021-12-31 /pmc/articles/PMC8743685/ /pubmed/35000355 http://dx.doi.org/10.15441/ceem.20.106 Text en Copyright © 2021 The Korean Society of Emergency Medicine https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ).
spellingShingle Original Article
Kim, Min Jae
Ha, Sang Ook
Park, Young Sun
Yi, Jeong Hyeon
Yang, Won Seok
Kim, Jin Hyuck
Validation and modification of HEART score components for patients with chest pain in the emergency department
title Validation and modification of HEART score components for patients with chest pain in the emergency department
title_full Validation and modification of HEART score components for patients with chest pain in the emergency department
title_fullStr Validation and modification of HEART score components for patients with chest pain in the emergency department
title_full_unstemmed Validation and modification of HEART score components for patients with chest pain in the emergency department
title_short Validation and modification of HEART score components for patients with chest pain in the emergency department
title_sort validation and modification of heart score components for patients with chest pain in the emergency department
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8743685/
https://www.ncbi.nlm.nih.gov/pubmed/35000355
http://dx.doi.org/10.15441/ceem.20.106
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