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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...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Emergency Medicine
2021
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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. |
format | Online Article Text |
id | pubmed-8743685 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | The Korean Society of Emergency Medicine |
record_format | MEDLINE/PubMed |
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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