Determınatıon of The Validity and Reliability of Chest Pain Risk Stratification Scores in Elderly Patients with Suspected Acute Coronary Syndrome in The Emergency Department

INTRODUCTION: This study aimed to investigate whether GRACE, TIMI, and HEART scores were reliable in predicting the major cardiac events (MACE) for six weeks of duration in patients older than 65 years, who were followed-up with the suspicion of acute coronary syndrome (ACS). METHODS: This single-center prospective observational study included patients over the age of 65 years who had presented to the emergency department (ED) of a tertiary hospital with acute chest pain. The development of MACE that had occurred within 6 weeks following the ED admission was evaluated RESULTS: A total of 181 patients were included in the study. The mean age of the patients was 73.9 years, and 61.9% were male. During six weeks of follow-up, MACE developed in 22 (12%) patients. MACE was observed in one (6.6%) of 15 patients with a HEART score of ≤ 3 points, in 6 (11.3%) of 53 patients with a TIMI score of ≤ 2 points, and in 4 (8.7%) of 46 patients with a GRACE score of

Göğüs Ağrısı İle Acil Servise Başvuran Akut Koroner Sendrom Şüphesi Olan Yaşlı Hastaların Değerlendirilmesinde Risk Skorlamalarının Geçerliliği ve Güvenilirliği

GİRİŞ ve AMAÇ: Göğüs ağrısı ile acil servise başvuran akut koroner sendrom (AKS) düşülerek takip edilen 65 yaş üzeri hastalarda 6 haftalık major kardiyak olay (MACE) görülme oranlarını ön görmede GRACE, TIMI, HEART skorlarının güvenli olup olmadığının araştırılmasıdır. YÖNTEM ve GEREÇLER: Bu tek merkezli prospektif gözlemsel çalışmaya 6 aylık dönemde 3. basamak eğitim araştırma hastanesi acil servisine göğüs ağrısı ile başvuran akut koroner sendrom düşünülen 65 yaş üzeri hastalar dahil edildi. Tüm hastalar için GRACE, TIMI, HEART skorları hesaplandı. İlk başvurudan itibaren 6 hafta içinde hastalardaki MACE gelişimi değerlendirildi. BULGULAR: Çalışmaya 181 hasta dahil edildi. Araştırmada yer alan hastaların ortalama yaşı 73.9 ve % 61.9’u erkekti. Hastaların 22’sinde (% 12.2) altı haftalık takip sonucunda MACE tespit edildi. HEART skoru ≤ 3 olan 15 hastanın 1’inde (%6.6), TIMI skoru ≤ 2 olan 53 hastanın 6’sında (%11.3) ve GRACE skoru

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1. College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2014 ;130(25):e344-426

2. Carlton EW, Khattab A, Greaves K. Identifying Patients Suitable for Discharge After a Single-Presentation High-Sensitivity Troponin Result: A Comparison of Five Established Risk Scores and Two High-Sensitivity Assays. Ann Emerg Med. 2015; 66:635-645.

3. Sakamoto JT, Liu N, Koh ZX, et al. Comparing HEART, TIMI, and GRACE scores for prediction of 30-day major adverse cardiac events in high acuity chest pain patients in the emergency department. Int J Cardiol 2016;221:759-64.

4. Chase M, Robey JL, Zogby KE, et al. Prospective Validation of the Thrombolysis in Myocardial Infarction Risk Score in the Emergency Department Chest Pain Population. Ann Emerg Med 2006;48(3):252-9.

5. Gupta R, Munoz R. Evaluation and Management of Chest Pain in the Elderly. Emerg Med Clin North Am 2016;34(3):523-42.

6. Forman DE, Alexander K, Brindis RG, et al. Improved Cardiovascular Disease Outcomes in Older Adults. F1000Research 2016, 5(F1000 Faculty Rev):112.

7. Hess EP, Brison RJ, Perry JJ, Calder LA, et al. Development of a clinical prediction rule for 30-day cardiac events in emergency department patients with chest pain and possible acute coronary syndrome. Ann Emerg Med 2012;59(2):115-25.

8. Backus BE, Six AJ, Kelder JC,et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol 2013; 168(3):2153-8.

9. Poldervaart JM, Langedijk M, Backus BE,et al. Comparison of the GRACE, HEART and TIMI score to predict major adverse cardiac events in chest pain patients at the emergency department. Int J Cardiol 2017;227:656-66.

10. Six AJ, Cullen L, Backus BE, Greenslade J, et al. The HEART score for the assessment of patients with chest pain in the emergency department: a multinational validation study. Crit Pathw Cardiol 2013;12(3):121-6.

11. Cullen L, Greenslade J, Hammett CJ,et al. Comparison of three risk stratification rules for predicting patients with acute coronary syndrome presenting to an Australian emergency department. Heart Lung Circ 2013;22(10):844-51.

12. Jaguszewski M, Ghadri JR, Diekmann J, et al. Acute coronary syndromes in octogenarians referred for invasive evaluation: treatment profile and outcomes. Clin Res Cardiol 2015;104(1):51-8.

13. Rosengren A, Wallentin L, Gitt AK, et al. Sex, age, and clinical presentation of acute coronary syndromes. Eur Heart J 2004;25(8):663-70.

14. Fuller M, Hamilton D, Holly J, Mallin M,et al. Prospective Evaluation of a Simplified Risk Stratification Tool for Patients With Chest Pain in an Emergency Department Observation Unit. Crit Pathw Cardiol 2013;12(3):132-6.

15. Amsterdam EA, Wenger NK, Brindis RG, Casey DE Jr, Ganiats TG, Holmes DR Jr, Jaffe AS, Jneid H, Kelly RF, Kontos MC, Levine GN, Liebson PR, Mukherjee D, Peterson ED, Sabatine MS, Smalling RW, Zieman SJ; ACC/AHA Task Force Members. 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American
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  • ISSN: 2147-0758
  • Başlangıç: 2012
  • Yayıncı: -
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