Abstract
Background: Undifferentiated chest pain stands out as both frequent and potentially
dangerous. Conventional reliance on cardiovascular risk factors alone is frequently
inadequate when clinicians attempt to separate true acute coronary syndrome (ACS)
from benign causes. The HEART score, has seen little investigation within high-risk
Egyptian populations. Accordingly, the present work assessed how well this tool
performs at forecasting 30-day Major Adverse Cardiovascular Events (MACE) and at
flagging low-risk individuals who may be discharged early and safely.
Methods: A prospective observational study at Benha University Hospital, the
investigation enrolled 260 ED attendees whose acute chest pain raised suspicion of a
cardiac origin. Each participant had a baseline HEART score recorded and was then
tracked across a 30-day window for any MACE. The discriminative performance of the
score was examined through Receiver Operating Characteristic (ROC) analysis, with
particular attention paid to the Negative Predictive Value (NPV).
Results: Within the 30-day window, MACE occurred in 21.5% (n = 56) of the cohort.
Median HEART scores ran markedly higher among those who reached this endpoint
than among those who did not (7 vs. 4, p < 0.001). For predicting 30-day MACE the
score reached strong diagnostic accuracy (AUC = 0.945), together with an
exceptionally high NPV (96.7% for MACE; 98.9% for mortality). An adverse event
was recorded in just one patient classified as low-risk.
Conclusion: Within the Egyptian ED setting, Beyond forecasting 30-day MACE
reliably, the HEART score supplied strong diagnostic value when the aim is to pinpoint
low-risk candidates appropriate for early discharge. |
