Does the HEART Pathway identify patients at low risk of a major adverse cardiac event at 1-year without increasing health care utilization?
BEEM Bottom Line
Why is this study important?
Chest pain is one of the most common presenting symptoms seen in the emergency department (ED). Decreasing the number of patients who undergo stress testing or cardiac imaging could lead to a decrease in false positive tests. False positives increase the overall cost to the system and expose patients to unnecessary risks during invasive testing such as angiography. A pathway that could safely and reliably identify patients who do not require further evaluation will save time and money for both the health system and the patient. The HEART Pathway combines the HEART score with serial cardiac troponin measurements for ED patients with suspected acute coronary syndrome (ACS). This analysis was to determine whether patients identified as low-risk by the HEART Pathway (defined as HEART score 0–3 and negative troponins at 0- and 3-hours) would have a 1-year major adverse cardiac event (MACE) rate of < 1% without increase in health care utilization.
Which, if any, threats to validity are most likely to have an impact on the results and how?
Thank you for your interest in the BEEM Journal!
To read the rest of this article or to access the entire collection of BEEM Critical Appraisals, please purchase a subscription at the link below.
If you would like a pre-view, click here to view some sample articles
- Article Number
- 170501
- Research Question
- Is it safe to rule out acute pulmonary embolism with stand-alone D-dimer testing below 750 µg/L?
- Article Number
- 160404
- Research Question
- What are the latest recommendations for the management of venous thromboembolism?
- Article Number
- 160205
- Research Question
- How well does oblique angle chest X-ray identify occult pneumothorax in trauma patients?
- Article Number
- 160101
- Research Question
- Is continuous positive airway pressure by helmet effective in the treatment of infants with bronchiolitis?
Premium Content Available Through Subscription
BEEM is a knowledge translation project which aims to extract the most recent, EM relevant, and valid evidence from the volumes of available medical research and deliver it to EM practitioners in an easily consumable format to help guide their clinical practice. This valuable distilled information provided by BEEM is available through BEEM's accredited CME courses or through our online journal.
A BEEM Journal Subscription will provide you with unlimited access to our entire collection of Critical Appraisals for 1 year.