Value of HEART score combined with three bedside tests of myocardial infarction in the diagnosis and prognosis of emergency chest pain / 中国医师杂志

ABSTRACT

Objective:To explore the value of HEART score combined with three bedside tests of myocardial infarction in the diagnosis of emergency chest pain patients.Methods:310 patients with emergency chest pain treated in Langfang People's Hospital from January 2018 to December 2018 were retrospectively selected. The HEART score was evaluated at admission, and the levels of serum creatine kinase isoenzyme (CK-MB), myoglobin (Myo) and troponin I (cTnI) were detected.Results:Among 310 patients, 232 cases were diagnosed as cardiogenic chest pain, 78 cases were non cardiogenic chest pain; In cardiogenic chest pain, 151 cases were acute coronary syndrome and 81 cases were stable angina pectoris; The HEART score, CK-MB, Myo and cTnI in patients with cardiogenic chest pain were (5.00±1.01)points, (14.45±3.11)ng/ml, (60.20±11.34)ng/ml and (2.30±0.89)ng/ml, respectively, which were significantly higher than those in patients with non cardiogenic chest pain ( P<0.05); The HEART score, CK-MB, myo and cTnI in patients with acute coronary syndrome were (5.83±1.12), (16.02±2.88)ng/ml, (64.49±12.01)ng/ml and (2.54±0.91)ng/ml, which were significantly higher than those in patients with stable angina pectoris ( P<0.05); The area under receiver operating characteristic (ROC) curve of HEART score combined with myocardial infarction in the diagnosis of cardiogenic chest pain was 0.811 ( P<0.05), which was higher than single diagnosis of other indexes; the sensitivity and specificity were 85.28% and 82.50% respectively; The area under ROC curve of HEART score combined with myocardial infarction in the diagnosis of acute coronary syndrome was 0.901 ( P<0.05), which was higher than single diagnosis of other indexes; the sensitivity and specificity were 90.00% and 85.00% respectively; The HEART score of patients with acute coronary death was (6.88±1.02), which was significantly higher than that of patients with survival ( P<0.05); The area under ROC curve predicted by HEART score was 0.674 ( P<0.05). When the cut-off value was 6, the sensitivity and specificity were 78.00% and 70.00%, respectively; the CK-MB, Myo and cTnI increased with the risk of cardiogenic chest pain ( P<0.05). Conclusions:HEART score combined with three bedside tests of myocardial infarction has a good application value in the emergency chest pain, which is worthy of clinical use.