HEART score effective in quickly identifying high-risk patients with chest pain

The HEART score appeared effective in assessing which patients with chest pain who visit the ER are at a high-risk for major adverse cardiac events, according to study results presented at the American College of Cardiology Scientific Session.

The HEART score could improve decision-making in hospitals nationwide and ensure patients who are at high-risk are quickly admitted to the ER for treatment, according to the researchers.

Already used in Europe, the HEART score has not yet been validated in the U.S.

Soumya Patnaik, MD, an internal medicine resident at Einstein Medical Center in Philadelphia, told Cardiology Today that the scoring system “helps in resource allocation and appropriate utilization of resources” by allowing emergency departments to more easily determine which patients require immediate intervention.

Patnaik and colleagues conducted a retrospective chart review of 170 patients – excluding STEMI – admitted for observation. The researchers evaluated the predictive value of HEART score in reaching endpoints and compared those results with the TIMI score. Nineteen patients reached at least one endpoint – defined as acute coronary syndrome (n = 19), 6-week major adverse cardiac event (n = 3) and death (n = 0).

Average HEART scores in patients with acute coronary syndrome and a major adverse cardiac event were 6.26, and 3.79 in patients who did not have any symptoms.

Patients who presented with a HEART score between 0 and 3 were immediately discharged. A score of 4 to 6 suggested admission for clinical observation. A HEART score ≥ 7 had a 72.72% risk for a major cardiac adverse event, which supported early invasive strategies.

The HEART score is different from existing scoring systems – such as TIMI, GRACE and PURSUIT – because, as Patnaik said, it “looks at patients with chest pain across a whole range of cardiac, as well as non-cardiac, chest pain” instead of focusing solely on those high-risk patients already presenting evidence of an acute coronary syndrome. – by Julie Gotchel

Reference:

Patnaik S, et al. Assessing the Patient with Chest Pain: Diagnostic Tools and Management Protocols. Presented at: American College of Cardiology Scientific Session; April 2-4, 2016; Chicago.

Disclosure: Patnaik reports no relevant financial disclosures.