Predicción de eventos adversos cardiovasculares mayores con dos escalas de riesgo para dolor torácico agudo en la emergencia

Jocabed Miranda-Chávez; José Amado-Tineo

doi:10.47487/apcyccv.v6i4.555

Authors

Jocabed Miranda-Chávez Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Perú. https://orcid.org/0000-0002-0912-3598
José Amado-Tineo Hospital Nacional Edgardo Rebagliati Martins, EsSalud, Lima, Perú. https://orcid.org/0000-0002-3286-4650

DOI:

https://doi.org/10.47487/apcyccv.v6i4.555

Keywords:

Chest Pain, Cardiovascular Diseases: Forecasting, Diagnosis

Abstract

Objectives. To compare the ability of the HEART and EDACS scores to predict major adverse cardiovascular events (MACE) at 30 days of follow-up in patients with acute chest pain presenting to an emergency department. Materials and Methods. Retrospective study of patients older than 18 years treated for acute chest pain, excluding ST-elevation acute coronary syndrome (ACS), trauma, and infections. The HEART and EDACS scores were assessed at admission. The area under the receiver operating characteristic curve (AUC), sensitivity, specificity, positive predictive value, and negative predictive value of both scores were calculated for the prediction of 30-day MACE. Results. A total of 249 patients were evaluated; 62.2% were male, with a mean age of 66.5 years. There were 25 MACEs (10%). The HEART score classified patients as low risk (43.4%), moderate risk (47.4%), and high risk (9.2%). Using the EDACS, patients were classified as low risk (38.6%) and not low risk (61.4%). Regarding MACE, the HEART score had an AUC of 0.91 (95% CI: 0.87–0.95) and EDACS had an AUC of 0.70 (95% CI: 0.60–0.79). For the diagnosis of ACS, the HEART score had an AUC of 0.85 (95% CI: 0.78–0.92) and EDACS 0.64 (95% CI: 0.55–0.72). The HEART score demonstrated better performance than EDACS, especially when a score ≥4 was obtained. Conclusions. The HEART score has higher diagnostic performance than EDACS for predicting MACE in patients with acute chest pain presenting to a tertiary emergency department.

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