HEART Pathway Outcomes at One Year

Written by Clay Smith

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At 12-month follow-up, no patients who were low risk on the HEART Pathway (HEART Score + 0/3-hour troponin) had major adverse coronary events (MACE*).  Those for whom the HEART Pathway was used did not have reduction in objective testing or ED visits over the next year.

Why does this matter?
The HEART Score and HEART Pathway were designed to help identify patients with low short-term risk of MACE (within 4-6 weeks), but how does this hold up after 12 months?

HEART still beating at 1-year
This was a long-term follow up of a previous RCT with 288 patients using the HEART Pathway for cardiac risk stratification.  No patients with a low-risk HEART Pathway, 0/66, had MACE at 12-month follow up, NPV 100%.  Use of the HEART Pathway did not reduce downstream ED visits or objective cardiac testing in the next 12 months.

*MACE: cardiac death, myocardial infarction, or coronary revascularization

Source
The HEART Pathway Randomized Controlled Trial One Year Outcomes.  Acad Emerg Med. 2018 Jun 19. doi: 10.1111/acem.13504. [Epub ahead of print]
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