6 7 The current study investigates two of these risk scores, namely the thrombosis in myocardial infarction (TIMI) score and the HEART score.įirst, the TIMI risk score was developed in 2000 to stratify risk in patients with chest pain admitted to the cardiac care unit (CCU) and can be used to predict 30-day outcomes of mortality, myocardial infarction (MI) and severe recurrent ischaemia requiring urgent revascularisation. Currently, international cardiac guidelines recommend the use of a risk score for risk stratification. Several risk stratification tools and prediction models have been developed over time. 4 The question remains whether this conservative approach leads to better clinical outcomes for patients and there is discussion on optimal management in patients who are deemed safe to discharge from the ED. However, often results of these performed tests are normal. Therefore, the majority of low-risk patients are currently admitted to the hospital to undergo further testing, regardless of low pretest probability. 3 Differentiating between low-risk and high-risk patients for ACS remains a diagnostic challenge, since a normal ECG and initially negative biomarkers do not exclude ACS. 1 2 Of all these patients, the majority has chest pain due to non-cardiac causes and only 15–20% of patients have an ACS. Each year, an estimated 6% of presentations at emergency departments (EDs) are attributed to symptoms suspicious of acute coronary syndrome (ACS).
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