title: Chest pain risk assessment in Indigenous and non-Indigenous Australians using HEART Score.
abstract: OBJECTIVE
  The objectives of this study were to investigate factors that correlate to cardiac events within 30 days in Indigenous and non-Indigenous Australians who present to ED with chest pain and to describe the predictive ability of the HEART Score in these groups.
  
  
  METHODS
  Patients who presented with chest pain between 1 January 2013 and 16 May 2013 in a university hospital were retrospectively enrolled in the study. HEART Scores were retrospectively assigned to participants. The study's end-point was Major Adverse Cardiac Events (MACE) within 30 days.
  
  
  RESULTS
  Participants (678) were enrolled in the study, of which 148 were Indigenous Australian. Twenty-eight percent of Indigenous Australian participants and 19% of non-Indigenous Australian participants were diagnosed with MACE within 30 days. Within the Indigenous Australian participant cohort, 1.6% of those with HEART Scores 0-3, 29% of those with HEART Scores 4-6 and 96% of those with HEART Scores 7-10 were diagnosed with MACE within 30 days. Within the non-Indigenous Australian participant cohort, 0.58% of those with HEART Scores 0-3, 17% of those with HEART Scores 4-6 and 79% of those with HEART Scores 7-10 were diagnosed with MACE within 30 days. The negative predictive value of HEART Scores 0-3 for ruling out MACE within 30 days was 98% for Indigenous participants and 99% for non-Indigenous participants.
  
  
  CONCLUSIONS
  The HEART Score is a reliable predictor of patient outcome in both Indigenous and non-Indigenous Australians. Modification of the HEART Score may not be required for use in the Indigenous Australian population who present to the ED with chest pain.
authors.affiliation: College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia.
authors.forename: Sarath Naidu
authors.initials: SN
authors.lastname: Bodapati
authors.affiliation: College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia.|Research and Development Unit, Primary Health Care Narhalsan, Boras, Sweden.|Department of Public Health and Community Medicine, Institute of Medicine, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Ronny
authors.initials: R
authors.lastname: Gunnarsson
authors.affiliation: College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia.
authors.forename: William John
authors.initials: WJ
authors.lastname: McBride
authors.affiliation: Cairns Hospital, Cairns, Queensland, Australia.
authors.forename: Richard
authors.initials: R
authors.lastname: Stone
authors.affiliation: Cairns Hospital, Cairns, Queensland, Australia.
authors.forename: Steven
authors.initials: S
authors.lastname: Sutcliffe
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000175:diagnosis*; D003327:Coronary Disease / Q000175:diagnosis*; D004562:Electrocardiography; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D044382:Population Groups; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012720:Severity of Illness Index; D014336:Troponin / Q000097:blood
chemical_list: D015415:Biomarkers; D014336:Troponin
keywords: Indigenous Australian; chest pain; emergency; heart score; risk stratification