Page 121 - EJMO-9-1

Eurasian Journal of Medicine and
Oncology
HEART and SYNTAX scores

The HEART score is a valuable, non-invasive, and rapid supports its potential utility in emergency settings,
tool for predicting the severity of CAD, particularly in allowing early treatment decisions for patients who cannot
emergency medical settings. Its simplicity and integration undergo immediate coronary angiography. Multivariate
of readily available clinical and laboratory data make it logistic regression analysis shows that the two independent
highly practical for triage and initial risk stratification. predictive factors for severe coronary lesions (moderate-
However, the real-world application of the HEART score to-high SYNTAX score) are men (OR = 4.412) and a
in emergency settings presents several challenges. HEART score of ≥5 (OR = 63.002).
A significant gap is the limited investigation into how Acknowledgment
treatment decisions based on the HEART score affect
patient outcomes. Although the score helps identify patients None.
at high risk, its effect on guiding interventions, such as
early angiography, medical therapy escalation, or hospital Funding
admission policies, remains unclear. For instance, does None.
implementing a treatment strategy informed by HEART
score thresholds improve outcomes such as mortality, Conflict of interest
revascularization rates, or hospital readmissions?
The authors declare no competing interests.
4.4. Limitations and future research
Author contributions
First, the relatively small sample size may reduce the
generalizability of findings across diverse populations and Conceptualization: All authors
clinical settings. Second, the observational nature of the Formal analysis: Vo Anh Tai
study limits causal inference. Although a correlation exists Investigation: Vo Anh Tai
between the HEART and SYNTAX scores, a direct cause- Methodology: Phan Thai Hao
and-effect relationship is unconfirmed. Future studies Writing – original draft: Vo Anh Tai
with larger cohorts and randomized designs can validate Writing – review & editing: All authors
the predictive utility of the HEART score and assess its
performance in comparison with other established risk Ethics approval and consent to participate
scores, such as TIMI, which is commonly used in NSTE- Ethics approval for this study was obtained from
ACS risk stratification. Biomedical Research of Pham Ngoc Thach University of
Future studies should evaluate the effect of HEART Medicine (No: 958/TĐHYKPNT-HĐĐĐ; signed date
score-guided treatment strategies on clinical outcomes December 19, 2023).
through randomized controlled trials, focusing on whether Consent for publication
it improves short- and long-term results such as mortality,
revascularization rates, and hospital readmissions. Written consent of research participants to publish their
Integrating the HEART score into real-time decision- data was obtained.
support systems could enhance its use in emergency care
by addressing workflow challenges. Moreover, further Availability of data
research should explore the combination of the HEART Data are available from the corresponding author on
score and advanced imaging techniques such as computed reasonable request.
tomography coronary angiography to non-invasively
predict coronary complexity and potentially reduce the References
need for invasive procedures. Finally, integrating the 1. Rott D, Leibowitz D. STEMI and NSTEMI are two distinct
HEART score into machine-learning models can optimize pathophysiological entities. Eur Heart J. 2007;28(21):2685.
risk stratification, providing personalized treatment
recommendations and improving patient outcomes, doi: 10.1093/eurheartj/ehm368
particularly in resource-limited settings. 2. Brown JC, Gerhardt TE, Kwon E. Risk factors for coronary
artery disease. In: StatPearls. Treasure Island, FL: Publishing
5. Conclusion LLC.; 2024.
The HEART score is a promising predictive tool for 3. Byrne RA, Rossello X, Coughlan JJ, et al. 2023 ESC Guidelines
assessing coronary artery lesion complexity in patients for the management of acute coronary syndromes. Eur Heart
with NSTE-ACS. Its correlation with the SYNTAX score J. 2023;44:3720-3826.

Volume 9 Issue 1 (2025) 113 doi: 10.36922/ejmo.5731