Risk Scores for Patients with Chest Pain: Evaluation in the Emergency Department
Risk Scores for Patients with Chest Pain: Evaluation in the Emergency Department
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DOI：
10.2174/157340311795677662
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发表时间：
2011-01-01
影响因子：
1.9
通讯作者：
Doevendans, P. A.
中科院分区：
文献类型：
--
作者：
Backus, B. E.;Six, A. J.;Doevendans, P. A.
胸痛是急诊科（艾德）的常见原因。无ST段抬高的急性冠状动脉综合征（NSTE-ACS）缺乏绝对标准。急性冠状动脉综合征（ACS）需要与其他可能引起胸痛的心脏和非心脏疾病区分开来，对于确诊的ACS患者，可以应用几种评分方法来区分冠心病监护病房中哪些患者可能从治疗中获益最多。PURSUIT、TIMI、GRACE和FRISC风险评分在这方面得到了很好的验证。然而，这些风险评分均未用于在紧急情况下识别ACS。绝大多数因ACS以外原因导致胸痛的患者在这些试验中未进行评价。一个基于证据的系统分层和政策，这些患者目前并不存在。最近开发的心脏评分是专门设计的分层所有胸痛患者在ED。心脏评分是在一项回顾性多中心研究验证，并证明是一个强有力的预测无事件生存率一方面和潜在的危及生命的心脏事件的另一方面。HEART评分有助于ED中胸痛患者的风险分层。
Chest pain is a common reason for presentation to the emergency department (ED). Absolute criteria for Acute Coronary Syndrome without ST elevation (NSTE-ACS) are lacking. An acute coronary syndrome (ACS) needs to be distinguished from a variety of other cardiac and non-cardiac diseases that may cause chest pain.For patients with confirmed ACS, several scoring methods can be applied in order to distinguish patients in the coronary care unit who may benefit most from therapies. The PURSUIT, TIMI, GRACE and FRISC risk scores are well validated with this respect. However, none of these risk scores has been used in the identification of an ACS in the emergency setting. The vast majority of patients with chest pain due to causes other than ACS were not evaluated in these trials. An evidence-based systematic stratification and policy for these patients does not currently exist.The more recently developed HEART score is specifically designed to stratify all chest pain patients in the ED. The HEART score was validated in a retrospective multicenter study and proved to be a strong predictor of event free survival on one hand and potentially life threatening cardiac events on the other hand. The HEART score facilitates risk stratification of chest pain patients in the ED.