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Chest pain risk assessment in Indigenous and non‐Indigenous Australians using HEART Score
Author(s) -
Bodapati Sarath Naidu,
Gunnarsson Ronny,
McBride William John,
Stone Richard,
Sutcliffe Steven
Publication year - 2016
Publication title -
emergency medicine australasia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.602
H-Index - 52
eISSN - 1742-6723
pISSN - 1742-6731
DOI - 10.1111/1742-6723.12527
Subject(s) - mace , medicine , indigenous , chest pain , cohort , heart failure , retrospective cohort study , cohort study , physical therapy , myocardial infarction , percutaneous coronary intervention , ecology , biology
Objective The objectives of this study were to investigate factors that correlate to cardiac events within 30 days in Indigenous and non‐Indigenous Australians who present to ED with chest pain and to describe the predictive ability of the HEART Score in these groups. Methods Patients who presented with chest pain between 1 January 2013 and 16 May 2013 in a university hospital were retrospectively enrolled in the study. HEART Scores were retrospectively assigned to participants. The study's end‐point was Major Adverse Cardiac Events (MACE) within 30 days. Results Participants (678) were enrolled in the study, of which 148 were Indigenous Australian. Twenty‐eight percent of Indigenous Australian participants and 19% of non‐Indigenous Australian participants were diagnosed with MACE within 30 days. Within the Indigenous Australian participant cohort, 1.6% of those with HEART Scores 0–3, 29% of those with HEART Scores 4–6 and 96% of those with HEART Scores 7–10 were diagnosed with MACE within 30 days. Within the non‐Indigenous Australian participant cohort, 0.58% of those with HEART Scores 0–3, 17% of those with HEART Scores 4–6 and 79% of those with HEART Scores 7–10 were diagnosed with MACE within 30 days. The negative predictive value of HEART Scores 0–3 for ruling out MACE within 30 days was 98% for Indigenous participants and 99% for non‐Indigenous participants. Conclusion The HEART Score is a reliable predictor of patient outcome in both Indigenous and non‐Indigenous Australians. Modification of the HEART Score may not be required for use in the Indigenous Australian population who present to the ED with chest pain.