A Comparison of the TIMI, GRACE and HEART Scores

• Occurence of MACE (Major Adverse Cardiac Events) [ Time Frame: 6 weeks after presentation ] [ Designated as safety issue: No ]
  The number of patients diagnosed with MACE (Acute Myocardial Infarction, Percutaneous Coronary Intervention, Coronary Artery Bypass Grafting, Significant stenosis with conservative therapy, Death)
  
  

• The number of patients undergoing Coronary ArterioGraphy (CAG) [ Time Frame: Three months after presentation ] [ Designated as safety issue: No ]
  
• The number of patients suffering Acute Coronary Syndrome (ACS) [ Time Frame: 3 months after presentation ] [ Designated as safety issue: No ]
  According to adjudication committee
  
  

This is a prospective, observational study in patients admitted to the emergency room for chest pain. All patients are checked by the resident in charge immediately on admission, before any lab values are known, by means of an admission Case Report Form (CRF), consisting of classical elements of patient history, risk factors, medication and physical examination. This CRF is filled out immediately by the resident. No additional effort will be asked of the patients.

Patient data during a follow up of at least 6 weeks are gathered from hospital charts.

The predictive value of the three scoring systems: HEART (History, ECG, Age, Risk factors, Troponin), TIMI (Thrombolysis in Myocardial Infarction) and GRACE (Global Registry of Acute Coronary Events) for both the discharge diagnosis and the occurrence of Major Adverse Cardiovascular Events (MACE) is calculated.

The primary hypothesis of the study is that the HEART score is a significantly better predictor than the TIMI and/or GRACE score for cardiovascular events during a six week period following admission to the emergency room.