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THE PREDICTIVE VALUE OF THE HEART SCORE FOR CORONARY LESIONS BASED ON THE SYNTAX SCORE IN PATIENTS WITH NON-ST-ELEVATION ACUTE CORONARY SYNDROME
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Abstract
Introduction: Non-ST-elevation acute coronary syndrome (NSTE-ACS) is prevalent in emergency settings, with lesion severity influencing treatment pathways. The SYNTAX score, determined through coronary angiography, accurately assesses lesion complexity but requires an invasive procedure. In contrast, the HEART score – based on clinical factors (History, ECG, Age, Risk factors, Troponin)—offers a non-invasive, rapid assessment tool. This study evaluates the HEART score’s effectiveness in predicting coronary lesion severity, as represented by the SYNTAX score, in NSTE-ACS patients. Methods: This cross-sectional study included 120 NSTE-ACS patients admitted to Trưng Vương Hospital from December 2023 to September 2024. Patients underwent HEART scoring and coronary angiography within 48 hours of admission. SYNTAX scores categorized patients into low (0–22), intermediate (23–32), or high-risk groups (≥33). Spearman’s correlation was used to assess the HEART-SYNTAX relationship, with receiver operating characteristic (ROC) analysis identifying the optimal HEART score cutoff for predicting SYNTAX ≥23. Results: The cohort’s mean age was 63.9 years, with 66.7% male. Common risk factors included hypertension (80.8%), hyperlipidemia (73.3%) and diabetes (25.8%). A significant positive correlation (ρ = 0.819, p < 0.001) was observed between HEART and SYNTAX scores, with higher HEART scores reflecting greater lesion complexity. ROC analysis yielded an area under the curve (AUC) of 0.912 (95% CI, 0.862–0.963), with a HEART score cutoff of 5 showing 90.6% sensitivity and 83.9% specificity for predicting moderate-to-high SYNTAX scores (≥ 23). Conclusion: The HEART score is an effective, non-invasive predictor of coronary lesion complexity in NSTE-ACS patients, correlating significantly with SYNTAX scores. A HEART score of ≥ 5 accurately identifies patients at risk for severe coronary disease, supporting its use in rapid, non-invasive risk stratification and facilitating timely intervention in emergency settings.
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Keywords
HEART score, SYNTAX score, Non-ST-Elevation Acute Coronary Syndrome, Predictive value.
References
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