PMID- 36726766 OWN - NLM STAT- PubMed-not-MEDLINE LR - 20230203 IS - 2168-8184 (Print) IS - 2168-8184 (Electronic) IS - 2168-8184 (Linking) VI - 15 IP - 1 DP - 2023 Jan TI - Improving Risk Stratification of Patients With Chest Pain in the Emergency Department. PG - e33202 LID - 10.7759/cureus.33202 [doi] LID - e33202 AB - OBJECTIVE: The HEARTS3 score is used to predict acute coronary syndrome by evaluating the findings of chest pain patients at the end of the second hour. Additionally, the American College of Cardiology (ACC)/American Heart Association (AHA) 2014 non-ST elevation acute coronary syndrome (NSTE-ACS) management guideline suggests assessing cardiac troponin levels at the third and sixth hours as a class 1A recommendation. This study aimed to explore the value of the HEARTS3 score for the evaluation of patients with chest pain and its utility for determining whether a patient is eligible for early discharge from the emergency department. MATERIAL AND METHODS: This study was prospectively conducted between March 1, 2016 to May 31, 2016 at the ED of the Research and Training Hospital in Istanbul. A total of 136 patients were evaluated, and HEARTS3 scores were calculated at the second, third, and sixth hours. Receiver operating characteristic (ROC) curves were used to calculate the specificity, sensitivity, negative predictive value (NPV) and positive predictive value (PPV) of these scores. The primary outcome was the occurrence of major adverse cardiac events (MACEs) within 30 days. RESULTS: In total, 29 patients with MACEs and 107 patients without MACEs were identified within 30 days. Based on the ROC curve, the cutoff value for early discharge was 6. The area under curve (AUC) values were 0.943, 0.963 and 0.976 at the second, third, and sixth hours, respectively. The sensitivity of the second-hour HEARTS3 score was 96.6%, and the NPV was 98.6%. Both the sensitivity and NPV reached 100% at the sixth hour. CONCLUSION: The HEARTS3 score was considered a feasible method for the prediction of MACEs. We concluded that a patient with a HEARTS3 score less than 6 may be discharged without serial troponin and ECG examination. CI - Copyright (c) 2023, Altunoz et al. FAU - Altunoz, Yusuf AU - Altunoz Y AD - Emergency Medicine Specialist, Sanliurfa Viransehir Devlet Hastanesi, Sanliurfa, TUR. FAU - Karakus Yilmaz, Banu AU - Karakus Yilmaz B AD - Emergency Department, Alanya Alaaddin Keykubat University, Medical School, Antalya, TUR. FAU - Topcu, Hatice AU - Topcu H AD - Emergency Medicine, Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, TUR. FAU - Cetinkal, Gokhan AU - Cetinkal G AD - Cardiology, Sisli Hamidiye Etfal Research and Training Hospital, Istanbul, TUR. FAU - Ikizceli, Ibrahim AU - Ikizceli I AD - Emergency Department, Istanbul University School of Medicine, Istanbul, TUR. FAU - Yigit, Yavuz AU - Yigit Y AD - Emergency Medicine, University of Health Sciences, Kocaeli Derince Training and Research Hospital, Kocaeli, TUR. LA - eng PT - Journal Article DEP - 20230101 PL - United States TA - Cureus JT - Cureus JID - 101596737 PMC - PMC9887456 OTO - NOTNLM OT - : acute coronary syndrome OT - anginal chest pain OT - early identification and diagnosis OT - emergency medi OT - hearts3 score COIS- The authors have declared that no competing interests exist. EDAT- 2023/02/03 06:00 MHDA- 2023/02/03 06:01 PMCR- 2023/01/01 CRDT- 2023/02/02 02:01 PHST- 2022/12/31 00:00 [accepted] PHST- 2023/02/02 02:01 [entrez] PHST- 2023/02/03 06:00 [pubmed] PHST- 2023/02/03 06:01 [medline] PHST- 2023/01/01 00:00 [pmc-release] AID - 10.7759/cureus.33202 [doi] PST - epublish SO - Cureus. 2023 Jan 1;15(1):e33202. doi: 10.7759/cureus.33202. eCollection 2023 Jan.