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Original Research

Open Access

Determining whether A Low HEART Score Is Associated with Low Risk in Coronary Angiography Results: Validation of HEART Score Using Coronary Angiography Results

  • PARK Jong-Hak1
  • YOON Young Hoon2
  • PARK Sung Jun2
  • LEE eu sun2
  • CHOI Sung-Hyuk2
  • CHO Young duck2

1Department of Emergency Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea

2Department of Emergency Medicine, Korea University Guro Hospital, Seoul, Republic of Korea

DOI: 10.22514/sv.2020.16.0084 Vol.17,Issue 1,January 2021 pp.56-62

Published: 08 January 2021

*Corresponding Author(s): CHO Young duck E-mail:


Purpose: The history, electrocardiogram, age, risk factor, and troponin (HEART) score have not yet been adopted in the emergency department (ED) in South Korea. We aimed to investigate whether patients with low HEART scores have a low risk of coronary angiography (CAG) results. Methods: Patients with chest pain with a possible cardiac etiology in the ED were included. Patients were divided into low-risk (0 – 3), intermediate-risk (4 – 6), and high-risk (7 – 9) groups according to the HEART score. We analysed the CAG results of the included patients. CAG results were divided into four grades: Grade I, > 70%; Grade II, > 50%; Grade III, 10% – 50%; and Grade IV, < 10%of stenosis. The occurrence of a major adverse cardiac event (MACE) within 28 days was also investigated. Results: The study included 787 patients, of whom 458, 262, and 67 were included in the low-risk, intermediate-risk, and high-risk groups, respectively. A total of 118 cases of MACE occurred (average: 0.15 MACE/patient). MACE incidence was lower in the low-risk HEART score group than in the intermediate-risk and high-risk groups (0.4% vs. 22.1% and 86.6%, p < 0.001). The CAG results of the admitted patients with a low-risk HEART score were as follows: Grade I, 6.1%; Grade II, 3.0%; Grade III, 27.3%; and Grade IV, 63.6%. Conclusions: Patients with a low HEART score visiting the ED in Korea had a low risk in CAG results and a low probability of developing MACE. The successful utilization of the HEART score appears to be a rational approach that may avoid unnecessary testing in chest pain patients presenting to the ED.


HEART score, Coronary angiography, Emergency department

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PARK Jong-Hak,YOON Young Hoon,PARK Sung Jun,LEE eu sun,CHOI Sung-Hyuk,CHO Young duck. Determining whether A Low HEART Score Is Associated with Low Risk in Coronary Angiography Results: Validation of HEART Score Using Coronary Angiography Results. SignaVitae. 2021. 17(1);56-62.


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