It is based on five elements including history, ECG, age, coronary risk factors, and troponin level 9. HEART score (HS) is valuable in risk stratification of patients presenting with chest pain 8. Scoring systems such as Heart score and Grace score are scoring systems that try to show the prognosis of patients according to their clinical status 6, 7 and the main expectation from these scoring systems is to be an indicator of coronary plaque burden and extent rather than determining the severity of coronary artery disease. Scoring systems such as SYNTAX and Gensini scores are basically scoring systems used to determine the extent and the severity of coronary artery disease and to determine treatment choice based on angiographic data 5 and these scoring systems have been used in some studies to determine the prognosis of patients and have been observed to have successful results. Therefore, the ability to reduce hospital costs and its burden on the public health system relies on the ability to correctly risk stratify patients which will also directly influence management plan 4. On the other hand, normal levels of troponin or normal electrocardiograms (ECGs) do not necessarily exclude the presence of ACS 3. Patients with CP are usually hospitalized and undergo further testing and even invasive procedures like coronary angiography which leads to unnecessary hospitalization and cost 1, 2. While chest pain (CP) is a major cause of referral to the emergency departments (ED), only less than 25% of these patients actually have acute coronary syndrome (ACS). The present study showed that the HEART score has a moderate and positive correlation with the SYNTAX score and HEART score with a cut-off value of 6 is a predictor for SYNTAX score of ≥ 23. We found that HEART Score of more than 6 is 52% sensitive and 74.7% specific to detect extensive coronary artery involvement (SNTAX score ≥ 23). Pearson correlation coefficient was 0.493 between HEART Score and SYNTAX score which was statistically significant (P < 0.001). 300 patients (65% female) with mean age of 58.42 ± 12.42 years were included. HEART and SYNTAX scores were calculated for all patients and their association was assessed. Coronary angiography was done via the femoral or radial route. Serum troponin I level was measured on admission and 6 h later. Data including age, gender, risk factors, comorbidities, 12-lead ECG, blood pressure and echocardiogram were recorded for all the participants. This multi-centric cross-sectional study investigated patients referred to the cardiac emergency departments of three hospitals between January 2018 and January 2020. We investigated the potential of HEART Score in detecting the existence and severity of coronary artery disease based on SYNTAX score. Clinical scoring systems such as the HEART score can predict major adverse cardiovascular events, but they cannot be used to demonstrate the degree and severity of coronary artery disease.
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