Chest pain in the emergency room: a multicenter validation of the HEART Score.
Chest pain in the emergency room: a multicenter validation of the HEART Score.
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DOI：
10.1097/hpc.0b013e3181ec36d8
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发表时间：
2010-09-01
影响因子：
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通讯作者：
Doevendans, Pieter A F M
中科院分区：
文献类型：
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作者：
Backus, Barbra E;Six, A Jacob;Doevendans, Pieter A F M
目的：胸痛患者的决策受到病史、心电图、年龄、危险因素和肌钙蛋白诊断能力差的影响。这些发现中的每一个都可能被评为0分、1分或2分。他们一起组成了心跳得分。我们测试了心脏评分预测主要不良心脏事件的假设。设计：对心脏病急诊室就诊的患者进行了回顾性多中心分析。设置：纳入2006年1月1日至3月31日的患者。患者：共有2161名患者入院，其中910名患者(42%)表现为胸痛。880例(96.7%)进行了分析。主要观察指标：主要终点包括急性心肌梗死、经皮冠状动脉介入治疗、冠状动脉搭桥术和发病后6周内死亡，这些因素一起称为主要不良心脏事件。结果：共有158例患者(17.95%)达到主要终点。急性心肌梗死92例(10.45%)，经皮冠状动脉介入治疗82例(9.32%)，冠状动脉搭桥术36例(4.09%)，死亡13例(1.48%)。在303例心脏评分从0到3的患者中，有3例(0.99%)有终点。在413例心脏评分4~6分的患者中，48例(11.6%)达到终点。当心脏评分在7~10分时，107/164例(65.2%)达到终点。结论：心脏评分有助于做出准确的诊断和治疗决定，而无需使用放射或侵入性操作。心脏评分是胸痛患者预后的一个简单、快速和可靠的预测指标，可用于分诊。
OBJECTIVE: Decision-making in chest pain patients is hampered by poor diagnostic power of patient's history, electrocardiogram, age, risk factors, and troponin. Each of these findings may be qualified with 0, 1, or 2 points. Together they compose the HEART score. We tested the hypothesis that the HEART score predicts major adverse cardiac events.DESIGN: Retrospective multicenter analysis in patients presenting at the cardiology emergency room.SETTING: Patient inclusion between January 1 and March 31, 2006.PATIENTS: A total of 2161 patients were admitted, of which 910 patients (42%) presented with chest pain. Analysis was performed in 880 cases (96.7%).MAIN OUTCOME MEASURES: The primary endpoint was a composite of acute myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft surgery and death, within 6 weeks after presentation, together called major adverse cardiac events.RESULTS: A total of 158 patients (17.95%) reached the primary endpoint. Ninety-two patients had an acute myocardial infarction (10.45%), 82 a percutaneous coronary intervention (9.32%), 36 a coronary artery bypass graft (4.09%), and 13 died (1.48%). Of 303 patients with HEART score 0 to 3, three (0.99%) had an endpoint. In 413 patients with HEART score 4 to 6, 48 cases (11.6%) reached an endpoint. In case of a HEART score of 7 to 10, an endpoint was reached in 107/164 cases (65.2%).CONCLUSIONS: The HEART score helps in making accurate diagnostic and therapeutic decisions without the use of radiation or invasive procedures. The HEART score is an easy, quick, and reliable predictor of outcome in chest pain patients and can be used for triage.