ArticleEmergency medicine journal : EMJ2020
Identification of very low-risk acute chest pain patients without troponin testing.
Article in Emergency medicine journal : EMJ, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
12 citing papers in PubMed, 30 citations in OpenAlex.
- Chest pain in the emergency room: value of the new HEAR score identifying patients with low risk of acute coronary syndrome without troponin testing.Clinics (Sao Paulo, Brazil) · 2026Article
- Cardiovascular Risk Assessment Tools in CKD.Clinical journal of the American Society of Nephrology : CJASN · 2026Review
- Evaluation and Comparison of Latent Health Risk Prediction Models for Clinical Triage: Protocol for a Mixed Methods Study.JMIR research protocols · 2026Article
- Temporal Trends and Clinical Implications of Cardiac Troponin Testing in Emergency Departments: A Multicenter Retrospective Study.Journal of clinical medicine · 2026Article
- Performance of computerized self-reported medical history taking and HEAR score for safe early rule-out of cardiac events in acute chest pain patients: the CLEOS-CPDS prospective cohort study.European heart journal. Digital health · 2025Article
- A Retrospective Validation of the HEAR Score.JACC. Case reports · 2024Article
- Pre-hospital evaluation of chest pain patients using the modified HEART-score: rationale and design.Future cardiology · 2024Observational
- Derivation of a HEAR Pathway for Emergency Department Chest Pain Patients to Safely Avoid a Second Troponin Test.Diagnostics (Basel, Switzerland) · 2023Article
- Article
- HEAR SCORE: A Proposal to Use Only Anamnestic and EKG Data to Evaluate Patients with Very Low Risk Chest Pain.Open access emergency medicine : OAEM · 2023Article
- A Closer Look at the HEART Score.Cardiology research · 2022Review
- Predictive Value of the HEART Score Combined with Hypersensitive C-Reactive Protein for 30 d Adverse Cardiovascular Events in Patients with Acute Chest Pain.Emergency medicine international · 2022Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 1 institution in 1 country.
Funding
Abstract
backgroundThe HEART Pathway combines a History ECG Age Risk factor (HEAR) score and serial troponins to risk stratify patients with acute chest pain. However, it is unclear whether patients with HEAR scores of
methodsA secondary analysis of the HEART Pathway Implementation Study was conducted. HEART Pathway risk assessments (HEAR scores and serial troponin testing at 0 and 3 hours) were completed by the providers on adult patients with chest pain from three US sites between November 2014 and January 2016. MACE (composite of death, myocardial infarction (MI) and coronary revascularisation) at 30 days was determined. The proportion of patients with HEAR scores of
resultsProviders completed HEAR assessments on 4979 patients and HEAR scores<1 occurred in 9.0% (447/4979) of patients. Among these patients, MACE at 30 days occurred in 0.9% (4/447; 95% CI 0.2% to 2.3%) with two deaths, two MIs and 0 revascularisations. The sensitivity and negative predictive value for MACE in the HEAR
conclusionThese data suggest that patients with HEAR scores of 0 and 1 represent a very low-risk group that may not require troponin testing to achieve a missed MACE rate <1%.
Indexed as
Identifiers
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.