Author + information
To compare the accuracy of Heart risk and GRACE risk for the prediction of major adverse cardiac events (MACE) in acute chest pain patients.
Total 209 patients (65.28 ± 16.85 years, 52.63% male) presented in ED with acute chest pain were enrolled. Clinical data and Heart, GRACE scores were collected from the original data. All causes leading to MACE were followed up at 30 days by Health Insurance Information System and call interview.
Compared with non MACE patients, the age, hypertension, ACS, SPO2, in-patient number, Heart and GRACE scores were significantly higher in MACE patients (P<0.05). The blood pressure at admission of MACE patients significantly decrease than that in non MACE patients (P<0.05). The c-statistics of Heart and GRACE were 0.910 (95% CI: 0.846 to 0.974) and 0.819 (95% CI: 0.735 to 0.902), respectively. For the purpose of accurately ruling out patients for 30-day MACE, a Heart score of ≤ 3 had a sensitivity and NPV of 100%, respectively, compared to 91.67% and 99.0% respectively, for GRACE ≤104. The percent of patients with 30-day MACE with Heart scores between 0 and 3, 4 to 6, and 7 to 10 was 0%, 2.5%, and 27%, respectively.
In acute chest pain patients at emergency department, the Heart scores are superior to the GRACE scores in predicting 30-day MACE.