| ObjectiveTo analyze the HEART score,the serum hypersensitive c-reactive protein(hs-CRP)levels in patients with acute chest pain,and the correlation between the combination of the two and major adverse cardiac events(MACE)in 30 days,and explore the value of applying HEART score combined with serum hs-CRP level to evaluate the early risk stratification in patients with acute chest pain.MethodsClinical data:This study is a follow-up study.A random selection of128 patients with acute chest pain admitted to the emergency department of the Second Affiliated Hospital of Shandong University of Traditional Chinese Medicine from November 2019 to October 2020 are enrolled.Case data collection and follow-up:After the patient is admitted to the hospital,a detailed medical history collection and physical examination will be carried out immediately,as well as other auxiliary examinations,such as electrocardiogram.The peripheral venous blood sample of the patient will be drawn at the same time to analysis relevant indicators,Such as blood creatinine,blood lipids,fasting blood sugar,cardiac troponin I(c Tn I)and hs-CRP levels.Next procedure is to follow up patients by telephone or review and keep a record of the occurrence of MACE within 30 days from the admission.In our study,MACE is defined as occurrence of acute myocardial infarction,percutaneous coronary intervention,coronary artery bypass surgery,and deaths related to above events.Data analysis:Researchers employed the HEART score to evaluate the early risk of those patients,and divided patients into high-risk group,intermediate-risk group and low-risk group according to the total score.Researchers use SPSS 26.0 to draw receiver operating characteristic(ROC)curve to analyze the predictive value of serum hs-CRP level,HEART score,HEART score combined with serum hs-CRP level for occurrence of MACE in patients with acute chest pain within 30 days from the admission.Researchers use Excel to check the input data and SPSS 26.0software for statistical analysis,P<0.05 means the difference is statistically significant.ResultsThere are 26,80,and 22 patients in the high-risk group,intermediaterisk group,and low-risk group,respectively.The number of totle events of MACE in each group within 30 days of follow-up period is 13,25,and1,respectively.1.The HEART score of the high-risk group is higher than that of the middle-risk group and the low-risk group,and the HEART score of the middlerisk group is higher than that of the low-risk group,the difference is statistically significant(P<0.05).Using the ROC curve to analyze the HEART score,the area under curve(AUC)of MACE in patients with acute chest pain during follow-up is 0.710(SE=0.048,P=0.000,95%CI 0.612-0.807),which indicates the HEART score is an independent indicator to predict the occurrence of MACE in patients with acute chest pain,and has accuracy in some extent.2.Comparing the hs-CRP levels of the three groups,it is found that the serum hs-CRP level of the high-risk group is higher than that of the intermediate-risk group and the low-risk group,and the hs-CRP level of the intermediate-risk group is higher than that of the low-risk group,and the difference is statistically significant(P<0.05),indicating the serum hsCRP level of patients with acute chest pain is related to the risk stratification.Using ROC curve to analyze the serum hs-CRP level in patients with acute chest pain,the AUC of MACE during follow-up is0.685(SE=0.049,P=0.002,95%CI 0.587-0.782),which indicates that the serum hs-CRP level has ability to predict the occurrence of MACE in patients during follow-up,with good sensitivity and relatively poor specificity.3.Using the ROC curve to analyze the HEART score combined with serum hs-CRP level,the AUC of MACE in patients with acute chest pain during follow-up is 0.726(SE=0.046,P=0.001,95%CI 0.632-0.819)>higher than that of HEART score,which indicates that the combination of the two is meaningful,and can improve the ability to predict the occurrence of MACE in patients with acute chest pain during follow-up.Conclusion1.The HEART score can be employed as an independent indicator to predict the occurrence of MACE in patients with acute chest pain within 30 days from showing obvious symptoms;2.Serum hs-CRP levels has a certain value in the early risk stratification of patients with acute chest pain,with good sensitivity and relatively poor specificity;3.The combined application of HEART score and serum hs-CRP level can enhance the ability to predict the occurrence of MACE in patients with acute chest pain within 30 days from onset. |
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