การศึกษาการเกิดเหตุการณ์ไม่พึงประสงค์ทางหัวใจและหลอดเลือดที่ 6 สัปดาห์ในผู้ป่วยที่มี HEART Score ต่ำที่ได้รับการจำหน่ายจากห้องฉุกเฉิน

Suphatcha Maneepet

Authors

Suphatcha Maneepet Department of Emergency Medicine, Phaholpolpayuhasena Hospital, Kanchanaburi Province 71000

Keywords:

HEART Score, major adverse cardiovascular events, emergency department, chest pain

Abstract

Objectives: To determine the incidence of major adverse cardiovascular events (MACE) within six weeks in patients with low HEART Score discharged from the emergency department, and to investigate revisit rates and factors associated with MACE occurrence.

Methods: A prospective observational cohort study was conducted among patients aged 18 years and older presenting with chest pain to the emergency department at Phaholpolpayuhasena Hospital between April and November 2025. Patients with low HEART Score (0-3 points) who were discharged were enrolled. Six-week outcomes were assessed through telephone follow-up and hospital database review. Data were analyzed using descriptive statistics, Fisher’s exact test, and the Mann-Whitney U test.

Results: A total of 161 patients were enrolled with mean age of 49.7 ± 16.8 years, 54.7% were female, and 57.1% had no underlying diseases. The six-week MACE rate was 1.2% (2 cases), comprising one case of ST-elevation myocardial infarction (STEMI) and one case of non-ST-elevation myocardial infarction (NSTEMI). The revisit rate was 16.1%, mostly for non-cardiovascular causes. Having diabetes mellitus as a comorbidity was significantly associated with the occurrence of MACE (p = 0.020).

Conclusions: The HEART Score is an effective tool for risk stratification of patients presenting with chest pain in the emergency department. Patients with low HEART Score have a low MACE rate. However, patients with comorbid diabetes mellitus may require closer monitoring, despite having a low score.

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