Non Invasive Imaging (Echocardiography, Nuclear, PET, MR and CT)

1603 JACC March 21, 2017

Volume 69, Issue 11

HEART SCORE DOES NOT PREDICT THE SEVERITY OF ANATOMICAL CORONARY ARTERY DISEASE IN PATIENTS PRESENTING TO THE EMERGENCY DEPARTMENT WITH CHEST PAIN

Poster ContributionsPoster Hall, Hall CSaturday, March 18, 2017, 3:45 p.m.-4:30 p.m.

Session Title: Non Invasive Imaging: Prognostic Implications of CT AngiographyAbstract Category: 27. Non Invasive Imaging: CT/Multimodality, Angiography, and Non-CT AngiographyPresentation Number: 1247-239

Authors: Aishwarya Bhardwaj, Susan Graham, Stanley Fernandez, Umesh Sharma, Saurabh Malhotra, University at Buffalo, Buffalo, NY, USABackground: HEART Score (HS; range 0-10) has been shown to predict major adverse cardiac events in patients presenting to the Emergency Department (ED) with chest pain and is being increasingly utilized in the USA. Coronary CT angiography (CCTA) in the ED allows for rapid triaging of patients and carries prognostic value. We hypothesize that HS will predict the severity of CAD on CCTA in patients presenting to the ED with chest pain.Methods: Patients undergoing CCTA for acute chest pain in the ED between January 2014 to July 2016 were identified. HS and clinically significant variables were obtained from medical records. Coronary artery calcium score (CACS) and highest coronary stenosis was assessed for all patients. Multivariable regression analyses were performed to determine the association of HS with CACS and >50% coronary stenosis.Results: Of the 901 CCTA performed in the ED for chest pain, 286 (32%) were positive. The mean age and HS of the cohort was 55 years (65% males) and 3 (low risk HS <3: 66%), respectively. There was no difference in the severity of CACS or the prevalence of >50% coronary stenosis among those with high risk vs. low risk HS (figure). On multivariable regression analyses, HS was not a predictor of either CACS and >50% coronary stenosis (table).Conclusions: There is a poor relationship between HS and the severity of anatomical CAD among patients presenting to the ED with acute chest pain. These results suggest that HS, developed in Europe, needs prognostic validation in the US population.