The following is a summary of “High-Sensitivity HEART Pathway Safely Reduces Hospitalizations Regardless of Sex or Race in a Multisite Prospective US Cohort,” published in the October 2024 issue of Cardiology by Veasey et al.        

The high-sensitivity HEART (History, Electrocardiogram, Age, Risk factors, troponin) pathway helps risk-stratify patients with chest pain in the emergency department (ED) using high-sensitivity cardiac troponin I (hs-cTnI).  

Researchers conducted a prospective study to assess the safety and effectiveness of the high-sensitivity HEART pathway (hs-HP) by sex and race.  

They analyzed data from a pre−post interrupted time series study at five US ED, comparing outcomes between the traditional HEART pathway (pre-implementation: January 2019 to April 2020) and the high-sensitivity HEART pathway using hs-cTnI (post-implementation: November 2020 to February 2022). The primary outcomes were 30-day all-cause mortality, myocardial infarction, and hospitalization.  

The results showed 9,703 patients assessed by hs-HP, 48.6% of White patients and 55.4% of non-White patients were classified as rule-out (P<0.001), with similar rule-out rates among females (54.4%) and males (47.3%) (P<0.001). The 30-day death or myocardial infarction rate was 0.3% across all groups, regardless of sex or race. Post-implementation, 30-day hospitalization decreased by 17.2% for White patients (aOR 0.49, 95% CI: 0.45−0.52), 14.1% for non-White (aOR 0.53, 95% CI: 0.48−0.59), 15.6% for females (aOR 0.50, 95% CI: 0.46−0.54), and 16.6% for males (aOR 0.51, 95% CI: 0.47−0.56). No significant interaction was found between hs-HP and sex (P=0.69) or race (P=0.10).  

They concluded that the hs-HP pathway safely reduced 30-day hospitalizations regardless of sex or race.  

Source: onlinelibrary.wiley.com/doi/full/10.1002/clc.70027