Research Article
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Comparison of SVEAT and HEART scoring in acute chest pain

Year 2025, Volume: 7 Issue: 5, 546 - 550, 15.09.2025
https://doi.org/10.38053/acmj.1707632

Abstract

Aims: It is very important to evaluate patients presenting with chest pain in terms of major adverse cardiovascular events (MACE) and many risk scoring systems have been developed for this purpose. In this study, we aimed to evaluate the MACE prediction performance of the newly developed symptoms, history of vascular disease, electrocardiography, age and troponin (SVEAT) score for patients presenting with chest pain.
Methods: This study was designed as a retrospective observational clinical trial. MACE occurring within 30 days; Myocardial infarction (MI), percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) and sudden cardiac death were considered the primary endpoints of the study. Patients over 18 years of age presenting with chest pain were included in the study. Patients with ST segment elevation on electrocardiography (ECG), hemodynamic instability and traumatic chest pain were excluded.
Results: The study included 557 patients and the mean age was 54.52±12.56 and the age distribution range was 23-95. Significant results for SVEAT score (AUC:0.988, 95%CI:0.978-0.997, p<0.001) and history, electrocardiography, age, risk factors and troponin (HEART) score (AUC:0.960, 95%CI:0.942-0.979, p<0.001) were obtained from ROC analysis of the effect of SVEAT and HEART scores on MACE.
Conclusion: The newly developed SVEAT score was superior to the HEART score in predicting adverse negative cardiac events in patients presenting with chest pain.

References

  • Chang AM, Fischman DL, Hollander JE. Evaluation of chest pain and acute coronary syndromes. Cardiol Clin. 2018;36(1):1-12. doi:10.1016/j.ccl.2017.08.001
  • Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S. Heart disease and stroke statistics—2018 update: a report from the American Heart Association. Circulation. 2018;137(12):e67-e492. doi:10.1161/CIR.0000000000000558
  • Perk J, De Backer G, Gohlke H, Graham I, Reiner Ž, Verschuren M. European guidelines on cardiovascular disease prevention in clinical practice (version 2012). Eur Heart J. 2012;33(13):1635-1701. doi:10.1093/eurheartj/ehs092
  • SCORE2 working group and ESC Cardiovascular risk collaboration. SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J. 2021;42(25):2439-2454. doi:10.1093/eurheartj/ehab309
  • Türkiye Kalp ve Damar Hastalıkları Önleme ve Kontrol Programı 2015–2020 Klavuzu. Ankara: Anıl Matbaa Ltd. Şti; 2005. T.C. Sağlık Bakanlığı Yayın No: 988.
  • Fuller M, Hamilton D, Holly J, Mallin M, Rayner T, Eshenroder N. Prospective evaluation of a simplified risk stratification tool for patients with chest pain in an emergency department observation unit. Crit Pathw Cardiol. 2013;12(3):132-136. doi:10.1097/HPC.0b013e31829a79cd
  • Halpern EJ, Deutsch JP, Hannaway MM, Estepa AT, Kenia AS, Neuburger KJ. Cardiac risk factors and risk scores vs cardiac computed tomography angiography: a prospective cohort study for triage of ED patients with acute chest pain. Am J Emerg Med. 2013;31(10):1479-1485. doi:10.1016/j.ajem.2013.08.001
  • Akyea RK, Leonardi-Bee J, Asselbergs FW, Patel RS, Durrington P, Wierzbicki AS. Predicting major adverse cardiovascular events for secondary prevention: protocol for a systematic review and meta-analysis of risk prediction models. BMJ Open. 2020;10(7):e034564. doi: 10.1136/bmjopen-2019-034564
  • Antman EM, Cohen M, Bernink PJ, et al. The TIMI risk score for unstable angina/non–ST elevation MI: a method for prognostication and therapeutic decision making. JAMA. 2000;284(7):835-842. doi:10.1001/jama.284.7.835
  • Eagle KA, Lim MJ, Dabbous OH, et al. A validated prediction model for all forms of acute coronary syndrome: estimating the risk of 6-month postdischarge death in an international registry. JAMA. 2004;291(22): 2727-2733. doi:10.1001/jama.291.22.2727
  • Poldervaart JM, Reitsma JB, Koffijberg H, et al. The impact of the HEART risk score in the early assessment of patients with acute chest pain: design of a stepped wedge, cluster randomised trial. BMC Cardiovasc Disord. 2013;13(1):1-8. doi:10.1186/1471-2261-13-77
  • Sakamoto JT, Liu N, Koh ZX, et al. Comparing HEART, TIMI, and GRACE scores for prediction of 30-day major adverse cardiac events in high acuity chest pain patients in the emergency department. Int J Cardiol. 2016;221:759-764. doi:10.1016/j.ijcard.2016.07.147
  • Roongsritong C, Taha ME, Pisipati S, et al. SVEAT score, a potential new and improved tool for acute chest pain risk stratification. Am J Cardiol. 2020;127:36-40. doi:10.1016/j.amjcard.2020.04.009
  • Hollander JE, Than M, Mueller C. State-of-the-art evaluation of emergency department patients presenting with potential acute coronary syndromes. Circulation. 2016;134(7):547-564. doi:10.1161/CIRCULATIONAHA.116.021886
  • Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013;168(3):2153-2158.1 doi:10.1016/j.ijcard.2013.01.255
  • Backus BE, Six AJ, Kelder JC, et al. Chest pain in the emergency room: a multicenter validation of the HEART score. Crit Pathw Cardiol. 2010; 9(3):164-169. doi:10.1097/HPC.0b013e3181ec36d8
  • Poldervaart JM, Langedijk M, Backus BE, et al. Comparison of the GRACE, HEART and TIMI score to predict major adverse cardiac events in chest pain patients at the emergency department. Int J Cardiol. 2017;227:656-661. doi:10.1016/j.ijcard.2016.10.080
  • Van den Berg P, Body R. The HEART score for early rule out of acute coronary syndromes in the emergency department: a systematic review and meta-analysis. Eur Heart J Acute Cardiovasc Care. 2018;7(2):111-119. doi:10.1177/2048872617710788
  • Mahler SA, Hiestand BC, Goff DC Jr, Hoekstra JW, Miller CD. Can the HEART score safely reduce stress testing and cardiac imaging in patients at low risk for major adverse cardiac events? Crit Pathw Cardiol. 2011;10(3):128-133. doi:10.1097/HPC.0b013e3182315a85
  • Antwi-Amoabeng D, Roongsritong C, Taha M, et al. SVEAT score outperforms HEART score in patients admitted to a chest pain observation unit. World J Cardiol. 2022;14(6):454-461. doi:10.4330/wjc.v14.i8.454
  • Shahid MF, Malik A, Kashif N, Siddiqi FA, Hammad M, Saeed HA. Risk stratification of acute-onset chest pain: SVEAT score versus HEART and TIMI scores. Cureus. 2023;15(5):e39590. doi:10.7759/cureus.39590

Comparison of SVEAT and HEART scoring in acute chest pain

Year 2025, Volume: 7 Issue: 5, 546 - 550, 15.09.2025
https://doi.org/10.38053/acmj.1707632

Abstract

Aims: It is very important to evaluate patients presenting with chest pain in terms of major adverse cardiovascular events (MACE) and many risk scoring systems have been developed for this purpose. In this study, we aimed to evaluate the MACE prediction performance of the newly developed symptoms, history of vascular disease, electrocardiography, age and troponin (SVEAT) score for patients presenting with chest pain.
Methods: This study was designed as a retrospective observational clinical trial. MACE occurring within 30 days; Myocardial infarction (MI), percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) and sudden cardiac death were considered the primary endpoints of the study. Patients over 18 years of age presenting with chest pain were included in the study. Patients with ST segment elevation on electrocardiography (ECG), hemodynamic instability and traumatic chest pain were excluded.
Results: The study included 557 patients and the mean age was 54.52±12.56 and the age distribution range was 23-95. Significant results for SVEAT score (AUC:0.988, 95%CI:0.978-0.997, p<0.001) and history, electrocardiography, age, risk factors and troponin (HEART) score (AUC:0.960, 95%CI:0.942-0.979, p<0.001) were obtained from ROC analysis of the effect of SVEAT and HEART scores on MACE.
Conclusion: The newly developed SVEAT score was superior to the HEART score in predicting adverse negative cardiac events in patients presenting with chest pain.

Ethical Statement

The protocol for this study was approved by the the Local Ethics Committee of City Hospital (AEŞH-EK1-655-2023) and written informed consent was waived due to the retrospective nature of the study.

References

  • Chang AM, Fischman DL, Hollander JE. Evaluation of chest pain and acute coronary syndromes. Cardiol Clin. 2018;36(1):1-12. doi:10.1016/j.ccl.2017.08.001
  • Benjamin EJ, Virani SS, Callaway CW, Chamberlain AM, Chang AR, Cheng S. Heart disease and stroke statistics—2018 update: a report from the American Heart Association. Circulation. 2018;137(12):e67-e492. doi:10.1161/CIR.0000000000000558
  • Perk J, De Backer G, Gohlke H, Graham I, Reiner Ž, Verschuren M. European guidelines on cardiovascular disease prevention in clinical practice (version 2012). Eur Heart J. 2012;33(13):1635-1701. doi:10.1093/eurheartj/ehs092
  • SCORE2 working group and ESC Cardiovascular risk collaboration. SCORE2 risk prediction algorithms: new models to estimate 10-year risk of cardiovascular disease in Europe. Eur Heart J. 2021;42(25):2439-2454. doi:10.1093/eurheartj/ehab309
  • Türkiye Kalp ve Damar Hastalıkları Önleme ve Kontrol Programı 2015–2020 Klavuzu. Ankara: Anıl Matbaa Ltd. Şti; 2005. T.C. Sağlık Bakanlığı Yayın No: 988.
  • Fuller M, Hamilton D, Holly J, Mallin M, Rayner T, Eshenroder N. Prospective evaluation of a simplified risk stratification tool for patients with chest pain in an emergency department observation unit. Crit Pathw Cardiol. 2013;12(3):132-136. doi:10.1097/HPC.0b013e31829a79cd
  • Halpern EJ, Deutsch JP, Hannaway MM, Estepa AT, Kenia AS, Neuburger KJ. Cardiac risk factors and risk scores vs cardiac computed tomography angiography: a prospective cohort study for triage of ED patients with acute chest pain. Am J Emerg Med. 2013;31(10):1479-1485. doi:10.1016/j.ajem.2013.08.001
  • Akyea RK, Leonardi-Bee J, Asselbergs FW, Patel RS, Durrington P, Wierzbicki AS. Predicting major adverse cardiovascular events for secondary prevention: protocol for a systematic review and meta-analysis of risk prediction models. BMJ Open. 2020;10(7):e034564. doi: 10.1136/bmjopen-2019-034564
  • Antman EM, Cohen M, Bernink PJ, et al. The TIMI risk score for unstable angina/non–ST elevation MI: a method for prognostication and therapeutic decision making. JAMA. 2000;284(7):835-842. doi:10.1001/jama.284.7.835
  • Eagle KA, Lim MJ, Dabbous OH, et al. A validated prediction model for all forms of acute coronary syndrome: estimating the risk of 6-month postdischarge death in an international registry. JAMA. 2004;291(22): 2727-2733. doi:10.1001/jama.291.22.2727
  • Poldervaart JM, Reitsma JB, Koffijberg H, et al. The impact of the HEART risk score in the early assessment of patients with acute chest pain: design of a stepped wedge, cluster randomised trial. BMC Cardiovasc Disord. 2013;13(1):1-8. doi:10.1186/1471-2261-13-77
  • Sakamoto JT, Liu N, Koh ZX, et al. Comparing HEART, TIMI, and GRACE scores for prediction of 30-day major adverse cardiac events in high acuity chest pain patients in the emergency department. Int J Cardiol. 2016;221:759-764. doi:10.1016/j.ijcard.2016.07.147
  • Roongsritong C, Taha ME, Pisipati S, et al. SVEAT score, a potential new and improved tool for acute chest pain risk stratification. Am J Cardiol. 2020;127:36-40. doi:10.1016/j.amjcard.2020.04.009
  • Hollander JE, Than M, Mueller C. State-of-the-art evaluation of emergency department patients presenting with potential acute coronary syndromes. Circulation. 2016;134(7):547-564. doi:10.1161/CIRCULATIONAHA.116.021886
  • Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the HEART score for chest pain patients at the emergency department. Int J Cardiol. 2013;168(3):2153-2158.1 doi:10.1016/j.ijcard.2013.01.255
  • Backus BE, Six AJ, Kelder JC, et al. Chest pain in the emergency room: a multicenter validation of the HEART score. Crit Pathw Cardiol. 2010; 9(3):164-169. doi:10.1097/HPC.0b013e3181ec36d8
  • Poldervaart JM, Langedijk M, Backus BE, et al. Comparison of the GRACE, HEART and TIMI score to predict major adverse cardiac events in chest pain patients at the emergency department. Int J Cardiol. 2017;227:656-661. doi:10.1016/j.ijcard.2016.10.080
  • Van den Berg P, Body R. The HEART score for early rule out of acute coronary syndromes in the emergency department: a systematic review and meta-analysis. Eur Heart J Acute Cardiovasc Care. 2018;7(2):111-119. doi:10.1177/2048872617710788
  • Mahler SA, Hiestand BC, Goff DC Jr, Hoekstra JW, Miller CD. Can the HEART score safely reduce stress testing and cardiac imaging in patients at low risk for major adverse cardiac events? Crit Pathw Cardiol. 2011;10(3):128-133. doi:10.1097/HPC.0b013e3182315a85
  • Antwi-Amoabeng D, Roongsritong C, Taha M, et al. SVEAT score outperforms HEART score in patients admitted to a chest pain observation unit. World J Cardiol. 2022;14(6):454-461. doi:10.4330/wjc.v14.i8.454
  • Shahid MF, Malik A, Kashif N, Siddiqi FA, Hammad M, Saeed HA. Risk stratification of acute-onset chest pain: SVEAT score versus HEART and TIMI scores. Cureus. 2023;15(5):e39590. doi:10.7759/cureus.39590
There are 21 citations in total.

Details

Primary Language English
Subjects Emergency Medicine
Journal Section Research Article
Authors

Aynur Yurtseven 0000-0002-1554-0873

Cemil Kavalcı 0000-0003-2529-2946

Afşin Emre Kayıpmaz 0000-0002-3578-4015

Submission Date May 27, 2025
Acceptance Date July 22, 2025
Publication Date September 15, 2025
Published in Issue Year 2025 Volume: 7 Issue: 5

Cite

AMA Yurtseven A, Kavalcı C, Kayıpmaz AE. Comparison of SVEAT and HEART scoring in acute chest pain. Anatolian Curr Med J / ACMJ / acmj. September 2025;7(5):546-550. doi:10.38053/acmj.1707632

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