GIÁ TRỊ THANG ĐIỂM HEART TRONG DỰ ĐOÁN BIẾN CỐ TIM MẠCH CHÍNH NỘI VIỆN Ở BỆNH NHÂN HỘI CHỨNG VÀNH CẤP KHÔNG ST CHÊNH LÊN

Abstract

Background: Patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) remain at substantial risk for in-hospital major adverse cardiovascular events (MACE). Accurate early risk stratification is essential to inform timely clinical decisions. The HEART score has been proposed as a practical risk-assessment tool in this setting. Objective: To determine the optimal HEART score cut-off and to evaluate its predictive performance for in-hospital MACE among patients admitted with NSTE-ACS. Methods: We conducted a prospective cohort study of 140 consecutive patients with NSTE-ACS admitted to the Interventional Cardiology Department, Nhan Dan Gia Dinh Hospital, from December 2024 to July 2025. Results: The cohort had a mean age of 63.59 ± 11.55 years; 58,6% were male. Hypertension (76.4%) and dyslipidemia (50%) were the most common comorbidities. The overall in-hospital MACE event incidence was 23.6%. MACE rates in the low (0-3), intermediate (4-6), and high (7-10) HEART groups were 0%, 7.5% and 59.1%, respectively. ROC analysis identified a HEART score cut-off of 7 points for predicting in-hospital MACE (AUC 0.852; 95% CI 0.79–0.926; p < 0.01). HEART score ≥ 7 predicted MACE events with sensitivity 83.2%, specificity 78.8%, NPV 92.7% and PPV 59.1%. Conclusions: HEART score of 7 is a straightforward and effective instrument for risk stratification and prognostication of in-hospital MACE among patients with NSTE-ACS. Its integration into clinical practice holds the potential to refine therapeutic decision-making, ultimately leading to improved patient outcomes.