A Cross-Sectional Study on the Relationship between the HEART Score and the Severity of CAD using the SYNTAX Score in Patients with NSTEMI Admitted to the Emergency Department: A Study from Turkey

Background: The HEART score is a risk stratification tool for acute chest pain, evaluating history, ECG, age, risk factors, and troponin. The SYNTAX (synergy between percutaneous coronary intervention with TAXUS and cardiac surgery) score assesses the extent and complexity of coronary artery disease (CAD) and is widely used in patients undergoing coronary interventions. Aim: To determine the relationship between the HEART and SYNTAX scores in patients with non-ST elevation myocardial infarction (NSTEMI). Method: A total of 222 NSTEMI patients who underwent coronary angiography were included. The HEART score was calculated at admission, and all patients underwent angiography within 12 hours. SYNTAX was used to evaluate CAD severity. Patients were divided into two groups based on SYNTAX scores. Comparisons were made according to demographic data, laboratory findings, and risk factors. Variables associated with high SYNTAX scores were identified. A P value of < 0.05 was considered statistically significant. Results: The mean age was 63.67 ± 11.89 years, and 74.77% of the patients were male. Patients with high SYNTAX scores had significantly higher HEART scores and more frequent diabetes and hypertension. High HEART score (OR: 3.09; 95% confidence intervals [CI]: 2.06–4.63; P < 0.001) and diabetes mellitus (OR: 4.57; 95% CI: 1.44–14.47; P = 0.010) were independently associated with high SYNTAX scores. A HEART score >7.5 predicted high SYNTAX scores with 82.1% sensitivity and 84.3% specificity (area under curve [AUC]: 0.892; P < 0.001). A strong positive correlation was found between HEART and SYNTAX scores (P < 0.001, R² =0.672). Conclusion: The HEART score was significantly associated with the severity and complexity of CAD in patients with NSTEMI.