Validation of the HEART Score System in Emergency Department Patients with Chest Pain and Possible Acute Coronary Syndrome

Abstract

Chest pain is one of the most common complaints of patients seeking consult in the emergency room (ER). The HEART score is a novel scoring system that utilizes the patient’s history, electrocardiogram, age, risk factors, and troponin level (HEART) to aid clinicians in the stratification of patients with chest pain in the ER. This study aims to determine the validity of the HEART score in predicting outcome in patients with chest pain seen in our ER. Methods: Patients who presented with chest pain in the ER of the Philippine Heart Center were included in the study, and their HEART scores were determined prospectively. Patients were followed up for 30 days, and the occurrence of acute myocardial infarction, revascularization and/or death were noted. The sensitivity, specificity, and positive and negative predictive values were then calculated in each HEART score. Results: Three hundred twenty-eight patients were included. One hundred seventy-six patients (53.7%) reached at least one endpoint. HEART scores 0–3 yielded excellent sensitivity and negative predictive values. A score ≥7 showed high specificity and positive predictive values. The measured C-statistic for the HEART score was 0.951. Conclusion: The HEART score is an easy, reliable, and convenient scoring system for stratifying patients with chest pain in the ER. It can be applied in our local setting, and it has an excellent ability to predict the occurrence of adverse cardiac events. Keyword: HEART score