Retrospective Validation of HEART Score for Chest Pain Patients in the Emergency Department

Orhay Mirzapolos; Ryan Wagner; April Brill; Fred Lepore

doi:doi:10.11648/j.cmr.20211001.14

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Retrospective Validation of HEART Score for Chest Pain Patients in the Emergency Department

Orhay Mirzapolos, Ryan Wagner, April Brill, Fred Lepore

Published in Clinical Medicine Research (Volume 10, Issue 1)

Received: 4 January 2021 Accepted: 12 January 2021 Published: 25 January 2021

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Abstract

Acute chest pain is one of the most common presentations to the emergency department yet only about 10% of these cases are diagnosed with acute coronary syndrome. Emergency physicians are faced with the dilemma of determining the etiology of the chest pain and appropriately dispositioning the patient. The HEART score was created as a decision tool to aide emergency physicians in risk-stratification of chest pain patients. Despite the growing evidence surrounding the use of the HEART score, there remains a paucity of literature involving its efficacy in community hospitals in the United States. This is a multicenter retrospective validation study conducted on 500 patients with the chief complaint of chest pain who subsequently underwent diagnostic or therapeutic coronary angiography from 2013 to 2015 at four community hospitals. The HEART score was calculated based on emergency department documentations. The study found that a positive coronary angiogram had a higher percentage of high risk HEART scores than low risk HEART scores. The majority of positive coronary angiograms among the four campuses had HEART scores between the 4-6 range, the intermediate category. This data parallels the larger validation studies previously published pertaining to the HEART score. Thus, the HEART score is a valid screening score for determining risk of a major adverse cardiac event and facilitates disposition of patients from emergency departments in community hospitals.

Published in	Clinical Medicine Research (Volume 10, Issue 1)
DOI	10.11648/j.cmr.20211001.14
Page(s)	20-25
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

HEART Score, Chest Pain, Acute Coronary Syndrome, ACS

References

[1]	Jain T, Nowak R, Hudson M, et al. Short- and long-term utility of the HEART score in patient’s evaluated in the emergency department for possible acute coronary syndrome. Critical Pathways in Cardiology. 15.2 (2016): 40-45.
[2]	Backus BE, Six AJ, Doevendans PA, et al. Prognostic factors in chest pain patients: a quantitative analysis of the HEART score. Critical Pathways in Cardiology. 15.2 (2016): 50-55.
[3]	Backus BE, Six AJ, Kelder JC, et al. Chest pain in the emergency room: a multicenter validation of the HEART score. Critical pathways in Cardiology. 9.3 (2010): 164-196.
[4]	Mahler SA, Hiestnd BC, Goff DC et al. Can the HEART score safety reduce stress testing and cardiac imaging in patients at low risk for acute coronary syndrome? Critical Pathways in Cardiology. 10.3 (2011): 128-133.
[5]	Six AJ, Cullen L, Backus BE, et al. The HEART score for the assessment of patients with chest pain in the emergency department: a multinational validation study. Critical Pathways in Cardiology. 12.3 (2013): 121-126.
[6]	Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. International Journal of Cardiology. 168 (2013): 2153-2158.
[7]	Poldervaart JM, Reitsma JB, Backus BE, et al. Effect of using the HEART score in patients with chest pain in the emergency department. Annals of Internal Medicine. 166.10 (2017): 689-697.
[8]	Sakamoto JT, Liu N, Koh ZX, et al. Comparing HEART, TIMI, and GRACE scores for prediction of 30 day major adverse cardiac events in high acuity chest pain patients in the emergency department. International Journal of Cardiology. 221 (2016): 759-764.
[9]	Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room: value of the HEART score. Netherlands Heart Journal. 16.6 (2008): 191-196.
[10]	Wu WK, Yiadom, MY, Collins SP, et al. Documentation of HEART score discordance between emergency physician and cardiologist evaluation of ED patients with chest pain. American Journal of Emergency Medicine. 35 (2017): 132-135.
[11]	Wong CP, Lui CT, Sung JG, et al. Prognostic clinical prediction scores without clinical gestalt for patients with chest pain in the emergency department. The Journal of Emergency Medicine. 54.2 (2018): 176-185.
[12]	Long B, Oliver J, and Streitz M. The great and powerful HEART score: does it have a weakness. emDocs. http://www.emdocs.net/great-powerful-heart-score-weakness/

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Plain Text BibTeX RIS

APA Style

Orhay Mirzapolos, Ryan Wagner, April Brill, Fred Lepore. (2021). Retrospective Validation of HEART Score for Chest Pain Patients in the Emergency Department. Clinical Medicine Research, 10(1), 20-25. https://doi.org/10.11648/j.cmr.20211001.14

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ACS Style

Orhay Mirzapolos; Ryan Wagner; April Brill; Fred Lepore. Retrospective Validation of HEART Score for Chest Pain Patients in the Emergency Department. Clin. Med. Res. 2021, 10(1), 20-25. doi: 10.11648/j.cmr.20211001.14

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AMA Style

Orhay Mirzapolos, Ryan Wagner, April Brill, Fred Lepore. Retrospective Validation of HEART Score for Chest Pain Patients in the Emergency Department. Clin Med Res. 2021;10(1):20-25. doi: 10.11648/j.cmr.20211001.14

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@article{10.11648/j.cmr.20211001.14,
  author = {Orhay Mirzapolos and Ryan Wagner and April Brill and Fred Lepore},
  title = {Retrospective Validation of HEART Score for Chest Pain Patients in the Emergency Department},
  journal = {Clinical Medicine Research},
  volume = {10},
  number = {1},
  pages = {20-25},
  doi = {10.11648/j.cmr.20211001.14},
  url = {https://doi.org/10.11648/j.cmr.20211001.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20211001.14},
  abstract = {Acute chest pain is one of the most common presentations to the emergency department yet only about 10% of these cases are diagnosed with acute coronary syndrome. Emergency physicians are faced with the dilemma of determining the etiology of the chest pain and appropriately dispositioning the patient. The HEART score was created as a decision tool to aide emergency physicians in risk-stratification of chest pain patients. Despite the growing evidence surrounding the use of the HEART score, there remains a paucity of literature involving its efficacy in community hospitals in the United States. This is a multicenter retrospective validation study conducted on 500 patients with the chief complaint of chest pain who subsequently underwent diagnostic or therapeutic coronary angiography from 2013 to 2015 at four community hospitals. The HEART score was calculated based on emergency department documentations. The study found that a positive coronary angiogram had a higher percentage of high risk HEART scores than low risk HEART scores. The majority of positive coronary angiograms among the four campuses had HEART scores between the 4-6 range, the intermediate category. This data parallels the larger validation studies previously published pertaining to the HEART score. Thus, the HEART score is a valid screening score for determining risk of a major adverse cardiac event and facilitates disposition of patients from emergency departments in community hospitals.},
 year = {2021}
}

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TY  - JOUR
T1  - Retrospective Validation of HEART Score for Chest Pain Patients in the Emergency Department
AU  - Orhay Mirzapolos
AU  - Ryan Wagner
AU  - April Brill
AU  - Fred Lepore
Y1  - 2021/01/25
PY  - 2021
N1  - https://doi.org/10.11648/j.cmr.20211001.14
DO  - 10.11648/j.cmr.20211001.14
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 20
EP  - 25
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20211001.14
AB  - Acute chest pain is one of the most common presentations to the emergency department yet only about 10% of these cases are diagnosed with acute coronary syndrome. Emergency physicians are faced with the dilemma of determining the etiology of the chest pain and appropriately dispositioning the patient. The HEART score was created as a decision tool to aide emergency physicians in risk-stratification of chest pain patients. Despite the growing evidence surrounding the use of the HEART score, there remains a paucity of literature involving its efficacy in community hospitals in the United States. This is a multicenter retrospective validation study conducted on 500 patients with the chief complaint of chest pain who subsequently underwent diagnostic or therapeutic coronary angiography from 2013 to 2015 at four community hospitals. The HEART score was calculated based on emergency department documentations. The study found that a positive coronary angiogram had a higher percentage of high risk HEART scores than low risk HEART scores. The majority of positive coronary angiograms among the four campuses had HEART scores between the 4-6 range, the intermediate category. This data parallels the larger validation studies previously published pertaining to the HEART score. Thus, the HEART score is a valid screening score for determining risk of a major adverse cardiac event and facilitates disposition of patients from emergency departments in community hospitals.
VL  - 10
IS  - 1
ER  -

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Author Information

Orhay Mirzapolos

Department of Emergency Medicine, Midwestern University, Downers Grove, United States
Ryan Wagner

Department of Emergency Medicine, Midwestern University, Downers Grove, United States
April Brill

Department of Emergency Medicine, Midwestern University, Downers Grove, United States
Fred Lepore

Department of Emergency Medicine, Midwestern University, Downers Grove, United States

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Sections

Plain Text BibTeX RIS

APA Style

Orhay Mirzapolos, Ryan Wagner, April Brill, Fred Lepore. (2021). Retrospective Validation of HEART Score for Chest Pain Patients in the Emergency Department. Clinical Medicine Research, 10(1), 20-25. https://doi.org/10.11648/j.cmr.20211001.14

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ACS Style

Orhay Mirzapolos; Ryan Wagner; April Brill; Fred Lepore. Retrospective Validation of HEART Score for Chest Pain Patients in the Emergency Department. Clin. Med. Res. 2021, 10(1), 20-25. doi: 10.11648/j.cmr.20211001.14

Copy | Download

AMA Style

Orhay Mirzapolos, Ryan Wagner, April Brill, Fred Lepore. Retrospective Validation of HEART Score for Chest Pain Patients in the Emergency Department. Clin Med Res. 2021;10(1):20-25. doi: 10.11648/j.cmr.20211001.14

Copy | Download

@article{10.11648/j.cmr.20211001.14,
  author = {Orhay Mirzapolos and Ryan Wagner and April Brill and Fred Lepore},
  title = {Retrospective Validation of HEART Score for Chest Pain Patients in the Emergency Department},
  journal = {Clinical Medicine Research},
  volume = {10},
  number = {1},
  pages = {20-25},
  doi = {10.11648/j.cmr.20211001.14},
  url = {https://doi.org/10.11648/j.cmr.20211001.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.cmr.20211001.14},
  abstract = {Acute chest pain is one of the most common presentations to the emergency department yet only about 10% of these cases are diagnosed with acute coronary syndrome. Emergency physicians are faced with the dilemma of determining the etiology of the chest pain and appropriately dispositioning the patient. The HEART score was created as a decision tool to aide emergency physicians in risk-stratification of chest pain patients. Despite the growing evidence surrounding the use of the HEART score, there remains a paucity of literature involving its efficacy in community hospitals in the United States. This is a multicenter retrospective validation study conducted on 500 patients with the chief complaint of chest pain who subsequently underwent diagnostic or therapeutic coronary angiography from 2013 to 2015 at four community hospitals. The HEART score was calculated based on emergency department documentations. The study found that a positive coronary angiogram had a higher percentage of high risk HEART scores than low risk HEART scores. The majority of positive coronary angiograms among the four campuses had HEART scores between the 4-6 range, the intermediate category. This data parallels the larger validation studies previously published pertaining to the HEART score. Thus, the HEART score is a valid screening score for determining risk of a major adverse cardiac event and facilitates disposition of patients from emergency departments in community hospitals.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Retrospective Validation of HEART Score for Chest Pain Patients in the Emergency Department
AU  - Orhay Mirzapolos
AU  - Ryan Wagner
AU  - April Brill
AU  - Fred Lepore
Y1  - 2021/01/25
PY  - 2021
N1  - https://doi.org/10.11648/j.cmr.20211001.14
DO  - 10.11648/j.cmr.20211001.14
T2  - Clinical Medicine Research
JF  - Clinical Medicine Research
JO  - Clinical Medicine Research
SP  - 20
EP  - 25
PB  - Science Publishing Group
SN  - 2326-9057
UR  - https://doi.org/10.11648/j.cmr.20211001.14
AB  - Acute chest pain is one of the most common presentations to the emergency department yet only about 10% of these cases are diagnosed with acute coronary syndrome. Emergency physicians are faced with the dilemma of determining the etiology of the chest pain and appropriately dispositioning the patient. The HEART score was created as a decision tool to aide emergency physicians in risk-stratification of chest pain patients. Despite the growing evidence surrounding the use of the HEART score, there remains a paucity of literature involving its efficacy in community hospitals in the United States. This is a multicenter retrospective validation study conducted on 500 patients with the chief complaint of chest pain who subsequently underwent diagnostic or therapeutic coronary angiography from 2013 to 2015 at four community hospitals. The HEART score was calculated based on emergency department documentations. The study found that a positive coronary angiogram had a higher percentage of high risk HEART scores than low risk HEART scores. The majority of positive coronary angiograms among the four campuses had HEART scores between the 4-6 range, the intermediate category. This data parallels the larger validation studies previously published pertaining to the HEART score. Thus, the HEART score is a valid screening score for determining risk of a major adverse cardiac event and facilitates disposition of patients from emergency departments in community hospitals.
VL  - 10
IS  - 1
ER  -

Copy | Download