Page 22 - JSOM Fall 2021

APPENDIX B:
MAJOR ADVERSE CARDIAC EVENT (MACE) HEART SCORE

This section provides the predictive HEART score for a 6-week *The following are MACE risk factors:
risk of MACE.
• Hypertension
• Hypercholesterolemia
MACEs are defined as the following:
• Diabetes mellitus
• Acute myocardial infarction (MI) • Obesity (body mass index > 30 kg/m )
2
• Percutaneous coronary intervention (PCI) • Smoking (current, or smoking cessation < 1 month)
• Coronary artery bypass graft (CABG) • Positive family history for coronary artery disease
• Coronary angiography revealing procedurally correct- • Atherosclerotic disease
able stenosis managed conservatively • Prior MI, PCI, CABG, cerebrovascular accident/tran-
• Death due to any cause sient ischaemic attack or peripheral artery disease

TABLE B-2 MACE Heart Score The following are the score levels for MACE:
Highly suspicious 2 • 0 – 3: low risk; 1.7% found to have MACE
History Moderately suspicious 1 • 4 – 6: moderate risk; 16.6% found to have MACE
Slightly or non-suspicious 0 • 7 – 10: high risk; 50.1% found to have MACE
Significant ST-depression 2
ECG Nonspecific repolarization disturbance 1 Sources
Normal 0 1. Backus BE, Six AJ, Kelder JC, et al. A prospective validation of the
HEART score for chest pain patients at the emergency department.
≥ 65 years 2 Int J Cardiol 2013;168:2153–8.
Age > 45 – < 65 years 1 2. Backus BE, Six AJ, Kelder JC, et al. Chest pain in the emergency
≤ 45 years 0 room: a multicenter validation of the HEART Score. Crit Pathw
Cardiol 2010;9:164–9.
≥ 3 risk factors, or history of atherosclerotic 2 3. Six AJ, Backus BE, Kelder JC. Chest pain in the emergency room:
disturbance value of the HEART score. Neth Heart J 2008;16:191–6.
Risk Factors* 1 to 2 risk factors 1
No risk factors known 0
≥ 3x normal limit 2
Troponin > 1 – < 3x normal limit 1
≤ normal limit 0

20 | JSOM Volume 21, Edition 3 / Fall 2021