Herku, Anne (2025) Klinische uitkomsten bij patiënten met acute pijn op de borst en een intermediate HEART-score: een observationele studie. thesis, Medicine.
Full text available on request.Abstract
Background: Chest pain is a common complaint in emergency departments, but only a small percentage is caused by acute coronary syndrome (ACS). The HEART score aids in stratifying the risk of Major Adverse Cardiac Events (MACE), but the optimal management for patients with an intermediate HEART score (4–6) remains unclear. This study evaluates clinical outcomes, such as diagnostic procedures and MACE incidence within 6 weeks and 1 year after presentation. Methods: This retrospective, single-center cohort study included patients (≥18 years) with chest pain and an intermediate HEART score (4–6), who presented at Deventer Hospital between January 1 and October 1, 2020. Results: Of 434 included patients, 71 patients presented with an ACS and 26 patients received an alternative diagnosis. 335 patients were discharged without a definitive diagnosis, 49.3% of whom underwent non-invasive testing. Within 1 year, coronary angiography (CAG) was performed 51 times in this group. Overall MACE incidence was 18.0% within 6 weeks and 25.1% within 1 year. Among patients discharged without a diagnosis, 10.4% developed MACE within 1 year. Elevated troponin levels (OR: 4.134, CI: 1.872–9.129, p<0.001) and higher HEART scores (OR: 2.260, CI: 1.415–3.609, p<0.001) were strong independent predictors of MACE. Conclusion: Diagnostic testing is performed in half of patients with an intermediate HEART score. MACE incidence within 6 weeks and 1 year is 18.0% and 25.1%, respectively. Elevated troponin at presentation seemed to be associated with the development of MACE after discharge.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Sluis, dr. A.van der and Badings, dr. E.A. |
| Faculty: | Medical Sciences |
| Date Deposited: | 09 Mar 2026 14:43 |
| Last Modified: | 09 Mar 2026 14:43 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3902 |
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