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Risk Score for Predicting Cardiac Ischemic Events in Patient with Chest Pain

Purpose: To evaluate a patient with chest pain, normal serum troponin and no ST-segment deviation in the ECG using the score of Sanchis et al.

Description

Sanchis et al developed a clinical score that can help evaluate patients with chest pain, normal serum troponin concentrations and an ECG without ST-segment deviation. This can help identify a patient at risk for cardiac disease within 1 year. The authors are from the Universitat de Valencia and the Hospital Clinic Barcelona in Spain.


 

Patient selection: acute chest pain, normal serum troponin concentration and no ST-segment deviation on the ECG

 

Outcomes: dead or myocardial infarction within 1 year

 

Parameters:

(1) chest pain score (Geleijnse et al, above)

(2) number of chest pain episodes in past 24 hours

(3) age of the patient in years

(4) insulin-dependent diabetes mellitus

(5) previous percutaneous transluminal coronary angioplasty (PTCA)

 

Parameter

Finding

Points

chest pain score

< 10

0

 

>= 10

1

chest pain episodes

0 to 1

0

 

>= 2

1

age in years

< 67 years of age

0

 

>= 67 years of age

1

insulin-dependent diabetes

absent

0

 

present

2

previous PTCA

no

0

 

yes

1

 

total score =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 6

• The higher the score the greater the risk of myocardial infarction or death in 1 year.

 

Risk Score

Percent with Poor Outcome

0

0

1

3%

2

5%

3

18%

4, 5 or 6

30%

 


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Specialty

Objective

ICD-10