Antwi-Amoabeng D, Roongsritong C, Taha M, Beutler BD, Awad M, Hanfy A, Ghuman J, Manasewitsch NT, Singh S, Quang C, Gullapalli N. SVEAT score outperforms HEART score in patients admitted to a chest pain observation unit. World J Cardiol 2022; 14(8): 454-461 [PMID: 36160811 DOI: 10.4330/wjc.v14.i8.454]
Corresponding Author of This Article
Bryce David Beutler, MD, Doctor, Department of Internal Medicine, University of Nevada, Reno School of Medicine, 1155 Mill Street W-11, Reno, Nevada 89502, United States. brycebeutler@hotmail.com
Research Domain of This Article
Cardiac & Cardiovascular Systems
Article-Type of This Article
Retrospective Cohort Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Cardiol. Aug 26, 2022; 14(8): 454-461 Published online Aug 26, 2022. doi: 10.4330/wjc.v14.i8.454
SVEAT score outperforms HEART score in patients admitted to a chest pain observation unit
Daniel Antwi-Amoabeng, Chanwit Roongsritong, Moutaz Taha, Bryce David Beutler, Munadel Awad, Ahmed Hanfy, Jasmine Ghuman, Nicholas T Manasewitsch, Sahajpreet Singh, Claire Quang, Nageshwara Gullapalli
Daniel Antwi-Amoabeng, Moutaz Taha, Bryce David Beutler, Munadel Awad, Ahmed Hanfy, Jasmine Ghuman, Nicholas T Manasewitsch, Sahajpreet Singh, Claire Quang, Nageshwara Gullapalli, Department of Internal Medicine, Reno School of Medicine, University of Nevada, Reno, NV 89502, United States
Chanwit Roongsritong, Institute for Heart and Vascular Health, Renown Regional Medical Center, Reno, NV 89502, United States
Author contributions: Antwi-Amoabeng D and Roongsritong C helped design the research study and wrote the original draft of the manuscript; Taha M, Beutler BD, Awad M and Hanfy A contributed to data curation, validation, and formal analysis; Ghuman J, Manasewitsch NT, Singh S and Quang C contributed to data curation and helped review and edit the manuscript; Gullapalli N supervised the project from initiation to completion.
Institutional review board statement: The study protocol was reviewed and approved by the University of Nevada, Reno School of Medicine Institutional Review Board.
Informed consent statement: The study was conducted in accordance with the policies of the Institutional Review Board of the University of Nevada, Reno School of Medicine. The trial was conducted as a retrospective cohort study using anonymized data from existing records. Therefore, informed consent was not required.
Conflict-of-interest statement: The authors declare no actual or potential conflicts of interest or relationship with industry.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author upon reasonable request.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bryce David Beutler, MD, Doctor, Department of Internal Medicine, University of Nevada, Reno School of Medicine, 1155 Mill Street W-11, Reno, Nevada 89502, United States. brycebeutler@hotmail.com
Received: October 21, 2021 Peer-review started: October 23, 2021 First decision: April 7, 2022 Revised: May 21, 2022 Accepted: August 5, 2022 Article in press: August 5, 2022 Published online: August 26, 2022 Processing time: 299 Days and 10.2 Hours
ARTICLE HIGHLIGHTS
Research background
Cardiovascular disease is the leading cause of death worldwide. Early identification of patients at risk for major cardiovascular events can expedite treatment and significantly reduce morbidity and mortality.
Research motivation
Risk stratification scoring systems used to identify patients at risk of major cardiovascular events, including the History, Electrocardiography, Age, Risk factors and Troponin (HEART) score, are often ineffective and may exclude many patients who would benefit from urgent intervention.
Research objectives
We aimed to assess the value of a new risk stratification scoring system, the Symptoms, history of Vascular disease, Electrocardiography, Age, and Troponin (SVEAT), by comparing its performance to that of the HEART score among chest pain patients with low suspicion for acute coronary syndrome.
Research methods
We retrospectively reviewed medical records of 330 consecutive patients admitted to our clinical decision unit for acute chest pain between January 1st to April 17th, 2019. To avoid potential biases, investigators assigned to calculate the SVEAT, and HEART scores were blinded to the results of 30-d combined endpoint of death, acute myocardial infarction or confirmed coronary artery disease required revascularization or medical therapy [30-d major adverse cardiovascular event (MACE)].
Research results
A 30-d MACE was observed in 11 patients (3.33% of the subjects). The area under receiving-operator characteristic curve (AUC) of SVEAT score (0.8876, 95%CI: 0.82-0.96) was significantly higher than the AUC of HEART score (0.7962, 95%CI: 0.71-0.88), P = 0.03. Using logistic model, SVEAT score with cut-off of 4 or less significantly predicts 30-d MACE (odd ratio 1.52, 95%CI: 1.19-1.95, P = 0.001) but not the HEART score (odd ratio 1.29, 95%CI: 0.78-2.14, P = 0.32).
Research conclusions
The SVEAT score is superior to the HEART score as a risk stratification tool for acute chest pain in low to intermediate risk patients.
Research perspectives
In our study, the SVEAT score was superior to the HEART score as a risk stratification tool for acute chest pain in low to intermediate risk patients. Future research is warranted to evaluate the SVEAT score among large, heterogeneous populations and among high-risk individuals presenting with chest pain.
