ArticleAnnals of emergency medicine2020
HEART Pathway Implementation Safely Reduces Hospitalizations at One Year in Patients With Acute Chest Pain.
Article in Annals of emergency medicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.
- The role of information systems in emergency department decision-making-a literature review.Journal of the American Medical Informatics Association : JAMIA · 2024Pooled it
- An Investigation of the Factors Reducing the Use of Hospital Services: A Systematic Review.Health science reports · 2026Review
- Risk Stratification in Cardiovascular Medicine for Prognostic Assessment and Therapeutic Decision-Making: From Atrial Fibrillation to the Broader Disease Spectrum.Journal of arrhythmia · 2026Review
- Sex differences in acute chest pain care in a multisite U.S. emergency department cohort.The American journal of emergency medicine · 2026Observational
- Age Differences in Acute Chest Pain Care in a Multisite US Cohort.Clinical cardiology · 2026Observational
- Implementation of High-Sensitivity Troponin for Early Rule-Out of Acute Myocardial Infarction in Emergency Department.American journal of medicine open · 2025Article
- Assessing modified HEART scores with high-sensitivity troponin for low-risk chest pain in the emergency department.Internal and emergency medicine · 2025Observational
- Safety and Effectiveness of the High-Sensitivity Cardiac Troponin HEART Pathway in Patients With Possible Acute Coronary Syndrome.Circulation. Cardiovascular quality and outcomes · 2024Article
- Comparison of heart, grace and TIMI scores to predict major adverse cardiac events from chest pain in a Spanish health care region.Scientific reports · 2023Article
- Association of physician malpractice claims rates with admissions for low-risk chest pain.American journal of medicine open · 2023Article
Corrections and comments
- Commented on by
- Commented on byIn reply.2021
Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
STUDY
objectiveWe determine whether implementation of the HEART (History, ECG, Age, Risk Factors, Troponin) Pathway is safe and effective in emergency department (ED) patients with possible acute coronary syndrome through 1 year of follow-up.
methodsA preplanned analysis of 1-year follow-up data from a prospective pre-post study of 8,474 adult ED patients with possible acute coronary syndrome from 3 US sites was conducted. Patients included were aged 21 years or older, evaluated for possible acute coronary syndrome, and without ST-segment elevation myocardial infarction. Accrual occurred for 12 months before and after HEART Pathway implementation, from November 2013 to January 2016. The HEART Pathway was integrated into the electronic health record at each site as an interactive clinical decision support tool. After integration, ED providers prospectively used the HEART Pathway to identify patients with possible acute coronary syndrome as low risk (appropriate for early discharge without stress testing or angiography) or nonlow risk (appropriate for further inhospital evaluation). Safety (all-cause death and myocardial infarction) and effectiveness (hospitalization) at 1 year were determined from health records, insurance claims, and death index data.
resultsPreimplementation and postimplementation cohorts included 3,713 and 4,761 patients, respectively. The HEART Pathway identified 30.7% of patients as low risk; 97.5% of them were free of death and myocardial infarction within 1 year. Hospitalization at 1 year was reduced by 7.0% in the postimplementation versus preimplementation cohort (62.1% versus 69.1%; adjusted odds ratio 0.70; 95% confidence interval 0.63 to 0.78). Rates of death or myocardial infarction at 1 year were similar (11.6% versus 12.4%; adjusted odds ratio 1.00; 95% confidence interval 0.87 to 1.16).
conclusionHEART Pathway implementation was associated with decreased hospitalizations and low adverse event rates among low-risk patients at 1-year follow-up.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.