Predictive risk stratification using HEART (history, electrocardiogram, age, risk factors, and initial troponin) and TIMI (thrombolysis in myocardial infarction) scores in non-high risk chest pain patients: An African American urban community based hospital study

Medicine
Priyanka T BhattacharyaStephen E Kimmel

Abstract

Validated risk scoring systems in African American (AA) population are under studied. We utilized history, electrocardiogram, age, risk factors, and initial troponin (HEART) and thrombolysis in myocardial infarction (TIMI) scores to predict major adverse cardiovascular events (MACE) in non-high cardiovascular (CV) risk predominantly AA patient population.A retrospective emergency department (ED) charts review of 1266 chest pain patients where HEART and TIMI scores were calculated for each patient. Logistic regression model was computed to predict 6-week and 1-year MACE and 90-day cardiac readmission. Decision curve analysis (DCA) was constructed to differentiate between clinical strategies in non-high CV risk patients.Of the 817 patients included, 500 patients had low HEART score vs. 317 patients who had moderate HEART score. Six hundred sixty-three patients had low TIMI score vs. 154 patients had high TIMI score. The univariate logistic regression model shows odds ratio of predicting 6-week MACE using HEART score was 3.11 (95% confidence interval [CI] 1.43-6.76, P = .004) with increase in risk category from low to moderate vs. 2.07 (95% CI 1.18-3.63, P = .011) using TIMI score with increase in risk category from low to high an...Continue Reading

References

Oct 15, 1993·Annals of Internal Medicine·M J Sorrentino
Aug 11, 2000·JAMA : the Journal of the American Medical Association·E M AntmanE Braunwald
Aug 13, 2005·BMC Medical Informatics and Decision Making·Jeffrey A KlineJ Lee Garvey
Nov 24, 2005·JAMA : the Journal of the American Medical Association·Clifford J Swap, John T Nagurney
Nov 14, 2006·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Andrew J Vickers, Elena B Elkin
Jan 24, 2007·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Judd E HollanderFrances S Shofer
Feb 12, 2008·Medical Decision Making : an International Journal of the Society for Medical Decision Making·Ewout W Steyerberg, Andrew J Vickers
Jul 31, 2008·Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation·A J SixJ C Kelder
Jan 16, 2010·Annals of Emergency Medicine·Pamela L OwensRyan L Mutter
Jul 31, 2010·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Lenny LópezAlexander R Green
Sep 15, 2010·The American Journal of Emergency Medicine·Jesse M PinesJudd E Hollander
Oct 12, 2010·American Heart Journal·Kevin L ThomasEric D Peterson
Mar 28, 2012·The New England Journal of Medicine·Harold I LittJudd E Hollander
Jan 30, 2013·The Western Journal of Emergency Medicine·Lindsay E BrownMary T Hawn
Feb 16, 2013·Critical Pathways in Cardiology·Anthony M NapoliBethany Desroches
Mar 5, 2015·Circulation. Cardiovascular Quality and Outcomes·Simon A MahlerChadwick D Miller
Jan 27, 2016·BMJ : British Medical Journal·Andrew J VickersEwout W Steyerberg
Feb 18, 2016·Critical Pathways in Cardiology·Benjamin C SunCharles V Pollack
Nov 16, 2017·American Journal of Respiratory and Critical Care Medicine·Colin SwensonRuxana Sadikot

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Citations

Nov 6, 2020·The American Journal of Emergency Medicine·Katherine A HolmesHao Wang

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Software Mentioned

Stata
HEART

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