Page 116 - EJMO-9-1

Eurasian Journal of Medicine
and Oncology

ORIGINAL RESEARCH ARTICLE
Predictive value of the HEART score for coronary

lesions based on the SYNTAX score in patients
with non-ST-elevation acute coronary syndrome

Phan Thai Hao * and Vo Anh Tai 2
1
1 Department of Internal Medicine, Pham Ngoc Thach University of Medicine, Ho Chi Minh City,
Vietnam
2 Department of Cardiology, Trung Vuong Hospital, Ho Chi Minh City, Vietnam

Abstract

Non-ST-elevation acute coronary syndrome (NSTE-ACS) is a prevalent condition in
emergency settings, with lesion severity influencing treatment pathways. The SYNTAX
score is determined by coronary angiography, which accurately assesses lesion
complexity but is an invasive procedure. In contrast, the HEART score – based on
history, electrocardiogram, age, risk factors, and troponin – offers a non-invasive, rapid
assessment tool. This study evaluated the effectiveness of the HEART score in predicting
the severity of coronary lesions, as represented by the SYNTAX score, in patients with
NSTE-ACS. This cross-sectional study included 120 patients with NSTE-ACS admitted
to Trung Vuong Hospital between December 2023 and September 2024. Patients were
*Corresponding author: assessed for the HEART score and coronary angiography within 48 h of admission.
Phan Thai Hao
(haopt@pnt.eud.vn) The SYNTAX scores categorized patients into low- (0 – 22), moderate- (23 – 32), or
high-risk groups (≥33). Spearman’s correlation was used to assess the HEART–SYNTAX
Citation: Hao PT, Tai VA. Predictive
value of the HEART score for relationship, with receiver operating characteristic (ROC) analysis identifying the
coronary lesions based on the optimal HEART score cutoff for predicting SYNTAX ≥23. The mean age of the cohort
SYNTAX score in patients with was 63.9 years, of which 66.7% were men. Common risk factors included hypertension
non-ST-elevation acute coronary
syndrome. Eurasian J Med Oncol. (80.8%), hyperlipidemia (73.3%), and diabetes (25.8%). A significant positive correlation
2025;9(1):108-114. (ρ = 0.819, P < 0.001) was observed between the HEART and SYNTAX scores, with higher
doi: 10.36922/ejmo.5731 HEART scores reflecting greater lesion complexity than SYNTAX scores. ROC analysis
Received: October 30, 2024 yielded an area under the curve of 0.912 (95% CI: 0.862 – 0.963), with a HEART score
cutoff of 5 showing 90.6% sensitivity and 83.9% specificity for predicting moderate-
Revised: December 1, 2024
to-high SYNTAX scores (≥23). The HEART score is an effective, non-invasive predictor
Accepted: December 12, 2024 of coronary lesion complexity in patients with NSTE-ACS, significantly correlating
Published online: December 27, with the SYNTAX scores. A HEART score of ≥5 accurately identifies patients at risk for
2024 severe coronary disease, supporting its use in rapid, non-invasive risk stratification
Copyright: © 2024 Author(s). and facilitating timely intervention in emergency settings.
This is an Open-Access article
distributed under the terms of the
Creative Commons Attribution Keywords: HEART score; SYNTAX score; Non-ST-elevation acute coronary syndrome;
License, permitting distribution, Predictive value
and reproduction in any medium,
provided the original work is
properly cited.
Publisher’s Note: AccScience
Publishing remains neutral with 1. Introduction
regard to jurisdictional claims in
published maps and institutional Non-ST-elevation acute coronary syndrome (NSTE-ACS) represents a critical
affiliations burden in cardiovascular medicine due to its prevalence and complex diagnosis and

Volume 9 Issue 1 (2025) 108 doi: 10.36922/ejmo.5731