From January 2019 to June 2019, a total of 724 patients with acute chest pain who were admitted to the ED of an urban academic tertiary hospital in Qinhuangdao (China) had been recruited. Therefore, we conducted this study to investigate a new risk score for patients who suffered from acute chest pain with normal hs-TnI levels. Recently, there was no special risk score for acute chest pain patients without known CAD and ST-segment deviation and with normal hs-TnI level in the ED. However, the data of the Sanchis and Florence scores were derived from databases of 10 years ago when high-sensitivity troponin (hs-TnI) was not used. The TIMI and GRACE scores were developed for patients with ACS, the HEART score was developed for patients with the suspected ACS, the Sanchis score was developed for patients with chest pain, non-ST segment deviation ECG and normal troponin levels ( 5), and the Florence score was developed for patients with acute chest pain without known coronary artery disease (CAD) and with normal ECG and troponin levels ( 7). Several risk scoring systems, such as the thrombolysis in myocardial infarction (TIMI), the Global Registry of Acute Coronary Events (GRACE), HEART, Sanchis, and Florence scores, have been developed to aid in the risk stratification of patients with suspected or diagnosed ACS ( 3– 8). Guidelines suggest using risk scores in the ED for early stratification of patients with acute ischemic chest pain and selecting different treatment strategies for different prognoses ( 2). In the large and heterogeneous population, however, assessment of acute coronary syndrome (ACS) remains a major clinical challenge. The area under the curve (AUC) of the receiver operating characteristic (ROC) in the derivation cohort was 0.80 (95% CI: 0.76–0.83), while in the validation cohort, it was 0.79 (95% CI: 0.75–0.82).Ĭonclusion: A new risk score was developed for acute chest pain patients without known CAD and ST-segment deviation and with normal hs-TnI and may aid MACE risk assessment and patient triage in the ED.Ĭhest pain is one of the most common symptoms presenting among emergency department (ED) patients ( 1). The validation cohort showed a homogenous pattern with the derivation cohort when patients were stratified by score. A total of 105 patients in the validation cohort had serious adverse cardiac events. The results showed that four predictor variables were significant in the regression analysis-male, a history of chest pain, 60 years of age or older and with three or more coronary artery disease (CAD) risk factors. Results: A total of 724 patients were included in the derivation cohort. Furthermore, validation was performed in an independent cohort, i.e., 352 patients (validation cohort).

Predictor variables were selected by logistic regression analysis, and external validity was assessed in this study. The end point was the occurrence of major adverse cardiac events (MACE) within 3 months. Hs-TnI was measured in serum samples drawn on admission to the ED. Methods: In this study, patients with acute chest pain who were admitted to the emergency department (ED) of our hospital had been recruited. Objective: To investigate a new risk score for patients who suffered from acute chest pain with normal high-sensitivity troponin I (hs-TnI) levels. 2Department of Endocrinology, The First Hospital of Qinhuangdao, Qinhuangdao, China.1Department of Cardiology, The First Hospital of Qinhuangdao, Qinhuangdao, China.Chunpeng Ma 1, Xiaoli Liu 2 * and Lixiang Ma 1

Variables of timi risk score