Evidence map›Paper›PMID 37653699›Full record

ArticleKorean circulation journal2023

Modification of HEART Pathway for Patients With Chest Pain: A Korean Perspective.

Bora Chae, Shin Ahn, Youn-Jung Kim, Seung Mok Ryoo, Chang Hwan Sohn, Dong-Woo Seo, Won Young Kim

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Korean circulation journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Bora ChaeDepartment of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0002-4731-2250
Shin AhnDepartment of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. ans1023@gmail.com.ORCID https://orcid.org/0000-0001-8642-6552
Youn-Jung KimDepartment of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0003-1385-5836
Seung Mok RyooDepartment of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0002-2436-3311
Chang Hwan SohnDepartment of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0001-9747-0196
Dong-Woo SeoDepartment of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0001-8104-0247
Won Young KimDepartment of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.ORCID https://orcid.org/0000-0002-6904-5966

Funding

National Research Foundation of Korea NRF-2021R1G1A101056711
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe History, Electrocardiography, Age, Risk factors, and Troponin (HEART) pathway was developed to identify patients at low risk of a major adverse cardiac event (MACE) among patients presenting with chest pain to the emergency department.

methodsWe modified the HEART pathway by replacing the Korean cut-off of 25 kg/m² with the conventional threshold of 30 kg/m² in the definition of obesity among risk factors. The primary outcome was a MACE within 30 days, which included acute myocardial infarction, primary coronary intervention, coronary artery bypass grafting, and all-cause death.

resultsOf the 1,304 patients prospectively enrolled, MACE occurred in 320 (24.5%). The modified HEART pathway identified 37.3% of patients as low-risk compared with 38.3% using the HEART pathway. Of the 500 patients classified as low-risk with HEART pathway, 8 (1.6%) experienced MACE, and of the 486 low-risk patients with modified HEART pathway, 4 (0.8%) experienced MACE. The modified HEART pathway had a sensitivity of 98.8%, a negative predictive value (NPV) of 99.2%, a specificity of 49.0%, and a positive predictive value (PPV) of 38.6%, compared with the original HEART pathway, with a sensitivity of 97.5%, a NPV of 98.4%, a specificity of 50.0%, and a PPV of 38.8%.

conclusionsWhen applied to Korean population, modified HEART pathway could identify patients safe for early discharge more accurately by using body mass index cut-off levels suggested for Koreans.

Indexed as

Acute coronary syndromeBody mass indexChest painCoronary artery diseaseEmergency department

Identifiers

PMID37653699
PMCPMC10475686

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