关键词: 胸痛, HEART评分, GRACE评分

Abstract: Objective  To explore the clinical value of HEART score in predicting 30-day major adverse cardiovascular events(MACE) of acute non-traumatic chest pain. 
Methods  Of 645 patients with acute non-traumatic chest pain, 84 patients with pain caused by tumors and rheumatism and 11 patients who were lost to follow-up were excluded. Thus, a total of 550 patients were included in the study. HEART score and GRACE score were calculated respectively in all patients, and the incidence of MACE was recorded at 30-d follow-up. 
Results  Of all 550 patients with acute non-traumatic chest pain, 82(14.9%) developed MACE within 30 days. There were significant differences in age, smoking rate, combined hypertension rate, coronary heart disease rate, diabetes rate, HEART score and GRACE score between MACE group and non-MACE group(P＜0.05). Logistic regression analysis showed that age, HEART score and GRACE score were independent risk factors for 30-day MACE in patients with acute non-traumatic chest pain. ROC curves of HEART score and GRACE score were drawn to predict 30-day MACE in patients with chest pain. The area under the curve of HEART score was higher than that of GRACE score(P＜0.05). The incidence of MACE in high-risk group by HEART score was higher than that in high-risk group by GRACE score, the incidence of MACE in moderate-risk group by HEART score was higher than that in moderate-risk group by GRACE score, and the incidence of MACE in low-risk group was lower than that in low-risk group by GRACE score(P＜0.05). This suggested that patients rated as low risk according to the HEART score had a lower risk of MACE, and those rates as moderate or high risk had a higher risk of MACE. 
Conclusion  HEART score has a high clinical value in predicting 30-day MACE in the patients with acute non-traumatic chest pain. 

Key words: chest pain, HEART score, GRACE score