The following is a summary of “T-MACS score vs HEART score identification of major adverse cardiac events in the emergency department,” published in the November 2022 issue of Emergency Medicine by Akman, et al.

The main cause of death globally is ischemic heart disease, which is becoming more common. For a study, researchers sought to determine how well the HEART and T-MACS scores predicted major cardiac events (MACE) in individuals who had chest discomfort and had gone to the emergency room.

The investigation was completed prospectively in a single location. The subjects’ T-MACS and HEART scores and their demographic data were noted and computed. Major adverse cardiac events were defined as death, acute myocardial infarction (AMI), and the requirement for coronary revascularization. The significance threshold for the statistical analysis was set at P< 0.05, and SPSS (IBM Statistics, New York) version 24 was used.

A total of 514 patients were enrolled in the study, with a mean age of 52.01±19.10 years and a gender split of 55.3% female and 44.7% male. AMI was identified in a total of 78 instances (15.1%). Within a month, 8 patients (or %1.5) died, 12 patients (or % 2.3) received coronary artery bypass surgery, and 50 patients (or % 9.7) got the percutaneous coronary intervention. For the extremely low-risk categorization, the T-MACS score’s sensitivity and negative predictive values were 93.90% (86.3%-98.0%) and 97.7% (94.7%-99.0%), whereas the HEART score’s sensitivity and negative predictive values were 89.59% (77.3%-93.1%) and 96.6% (94.2%-98.0%), respectively. For the T-MACS score and the HEART score, respectively, the specificity and positive predictive values for the high-risk categorization were 99.77% (98.7%-100%) and 97.2% (82.9%-99.6%) and 93.14 (92.7%-97%) and 63.2% (51.4%-73.5%).

When predicting low risk (very low risk for the T-MACS score), high risk, and expected one-month risk for MACE in patients visiting the emergency room with chest pain, the T-MACS score has been proven more reliable than the HEART score.

Reference: sciencedirect.com/science/article/pii/S0735675722007124