Luis G. Abanto-Días, Sociedad Científica de Estudiantes de Medicina, Universidad Nacional del Santa; Escuela Profesional de Medicina Humana, Universidad Nacional del Santa; Nuevo Chimbote, Perú
Abigail R. Alcántara-Pinedo, Sociedad Científica de Estudiantes de Medicina, Universidad Nacional del Santa; Escuela Profesional de Medicina Humana, Universidad Nacional del Santa; Nuevo Chimbote, Perú
Breyson A. Ávila-Seminario, Sociedad Científica de Estudiantes de Medicina, Universidad Nacional del Santa; Escuela Profesional de Medicina Humana, Universidad Nacional del Santa; Nuevo Chimbote, Perú
Luis M. Aguirre-Pascual, Sociedad Científica de Estudiantes de Medicina, Universidad Nacional del Santa; Escuela Profesional de Medicina Humana, Universidad Nacional del Santa; Nuevo Chimbote, Perú
Guillermo A. Arana-Morales, Escuela Profesional de Medicina Humana, Universidad Nacional del Santa; EsSalud, Hospital III. Nuevo Chimbote, Perú
Introduction: Chest pain is one of the main reasons for consultation in emergency departments, often associated with ischemic heart disease and major adverse cardiovascular events (MACE). Proper assessment of these patients is crucial to identify the risk of MACE and optimize clinical management. Objective: To evaluate the prognostic accuracy of the HEART, EDACS, and T-MACS scores for predicting MACE in adult patients presenting to the emergency department with chest pain. Methods: Searches were conducted in PubMed and Scopus to identify studies evaluating the utility of the HEART, EDACS, and T-MACS scales in predicting short-term MACE. Two independent reviewers selected the studies according to eligibility criteria, extracted data, and assessed the risk of bias. Data were analyzed using STATA, and the GRADE approach was applied to determine the certainty of the evidence. Results: Five observational studies with a total of 3,537 participants were included. The HEART score showed an AUC of 0.88, with a sensitivity of 93% (95% CI: 86–96%). The T-MACS score stood out in specificity (70%; 95% CI: 66-74%), while the EDACS showed the lowest AUC (0.57; 95% CI: 0.53-0.61). Conclusions: Based on prognostic accuracy measures, the HEART score is highly sensitive for predicting major cardiovascular events (MACE), stratifying risk, and ruling out events in patients at low to intermediate risk. T-MACS has high specificity and favorable overall performance, making it valuable for ruling out MACE and optimizing hospital resources. In contrast, EDACS has limitations as a prognostic tool in emergency departments.
Keywords: Chest pain. Emergency medical services. Adult. Risk assessment.
