Performance of the SVEAT (Symptoms, Vascular Disease History, Electrocardiography, Age, and Troponin) score for predicting 90-day major adverse cardiac events in patients with acute chest pain.

backgroundIn the emergency department, chest pain is a common presentation, and the primary clinical challenge is the early identification of patients at risk of major adverse cardiac events (MACE). This study aimed to evaluate the diagnostic performance of the SVEAT (Symptoms, Vascular Disease History, ECG, Age, and Troponin) score in predicting 90-day MACE in patients presenting with acute chest pain.

methodsThis study included 348 patients presenting with acute chest pain. Serial high-sensitivity troponin I (HsTn-I) measurements were obtained at admission and 2 h later. Electrocardiographic and clinical data were recorded, and the SVEAT, HEART, and TIMI scores were calculated. Patients were followed for 90 days for MACE occurrence.

resultsMACE occurred in 7.2% of patients during the 90-day follow-up. The second high-sensitivity troponin I (HsTn-I) measurement was significantly associated with MACE (p = 0.007). The SVEAT score demonstrated the highest discriminative performance (AUC = 0.806), compared with the HEART score (AUC = 0.756) and TIMI score (AUC = 0.753). At the optimal cut-off value of 4, the SVEAT score showed a sensitivity of 0.56 and a specificity of 0.86. In comparison, both the HEART and TIMI scores (cut-off = 3) showed higher sensitivity (0.72), with specificity values of 0.72 and 0.63, respectively. CLINICAL TRIAL NUMBER: Not applicable.

conclusionThe SVEAT score may have potential as a rule-in tool for predicting 90-day MACE in emergency department patients presenting with acute chest pain, due to its higher specificity; however, this is accompanied by relatively low sensitivity, which limits its utility as a standalone screening tool.