{
  "abstract": "Background\n\nChest pain is a frequent reason for Emergency Department (ED) visits, although only a minority of patients ultimately present an Acute Coronary Syndrome (ACS). Current diagnostic strategies rely heavily on troponin testing, but a new clinical tool requiring no blood sampling, the HEAR score, has recently been proposed. This study aimed to evaluate the performance of the HEAR score for identifying low-risk patients presenting with chest pain, using 45-day Major Adverse Cardiovascular Events (MACE) as the primary outcome.Methods\n\nAll patients presenting with chest pain to the ED of Dijon University Hospital in 2019 were retrospectively analyzed in this single-center study. Patients were stratified as \"low risk\" (HEAR < 2) or \"high risk\" (HEAR ≥ 2). Outcomes assessed at 45-days included MACE (defined as a composite of all-cause death, non-fatal myocardial infarction, and urgent coronary revascularization) and recurrence of ED consultation for chest pain.Results\n\nAmong 2177 patients presenting with chest pain, 1807 met inclusion criteria. Of these, 653 (36%) were classified as low risk (HEAR < 2). At 45-days, 22 (3%) low-risk patients reconsulted for chest pain compared with 64 (6%) in the high-risk group (p = 0.037). No MACE was identified among low-risk patients within the available follow-up data. The negative predictive value of a HEAR score < 2 was 100% (95% CI: 99.5%-100%), with an upper 95% confidence bound for the event rate of 0.46%.Conclusion\n\nA HEAR score < 2 identifies a substantial proportion of ED chest pain patients at very low risk of short-term adverse cardiovascular events. However, given the limitations of retrospective follow-up and potential under-ascertainment of events, these findings should be considered hypothesis-generating. The HEAR score may contribute to early clinical risk stratification rather than replace troponin-based strategies.",
  "abstract_shown": true,
  "affiliations": [
    "Service de Cardiologie, CHU Dijon Bourgogne, PEC2 UR 7460, Université Bourgogne Europe, Dijon, France. Electronic address: thibaut.pommier@chu-dijon.fr.",
    "Service des Urgences, CHU Dijon Bourgogne, Université Bourgogne Europe, Dijon, France.",
    "Service de Cardiologie, CHU Dijon Bourgogne, PEC2 UR 7460, Université Bourgogne Europe, Dijon, France."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 7,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Thibaut Pommier",
      "orcid": "0000-0002-1637-8855"
    },
    {
      "affs": [
        1
      ],
      "name": "Eddy Portella"
    },
    {
      "affs": [
        2
      ],
      "name": "Pierre Guilleminot",
      "orcid": "0000-0003-0837-9150"
    },
    {
      "affs": [
        1
      ],
      "name": "Adrien Goldstein"
    },
    {
      "affs": [
        2
      ],
      "name": "Gabriel Laurent"
    },
    {
      "affs": [
        2
      ],
      "name": "Charles Guenancia",
      "orcid": "0000-0002-3554-7714"
    },
    {
      "affs": [
        1
      ],
      "name": "Patrick Ray"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/cvbkxv5v15b1d.bib",
  "cited_by": 0,
  "doi": "10.1016/j.clinsp.2026.101214",
  "fulltext_url": "https://europepmc.org/articles/PMC13691485",
  "id": "cvbkxv5v15b1d",
  "issns": [
    "1807-5932",
    "1980-5322"
  ],
  "landing_url": "https://europepmc.org/article/MED/42880133",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2705|Acute Myocardial Infarction Research"
    ]
  ],
  "openalex": "W7222161609",
  "pdf_url": "https://europepmc.org/articles/PMC13691485?pdf=render",
  "pmcid": "PMC13691485",
  "pmid": "42880133",
  "published": "2026-10-15",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/cvbkxv5v15b1d.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:46Z",
      "native_id": "MED:42880133",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42880133"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2705|Acute Myocardial Infarction Research",
      "subfield": "cardiovascular"
    }
  ],
  "title": "Chest pain in the emergency room: value of the new HEAR score identifying patients with low risk of acute coronary syndrome without troponin testing.",
  "title_text": "Chest pain in the emergency room: value of the new HEAR score identifying patients with low risk of acute coronary syndrome without troponin testing.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:46Z",
  "url": "https://research.draconitic.com/paper/cvbkxv5v15b1d",
  "venue": "Clinics (Sao Paulo, Brazil)",
  "versions": []
}