URGENT 1.5: diagnostic accuracy of the modified HEART score, with fingerstick point-of-care troponin testing, in ruling out acute coronary syndrome

L.H. Koper, L.D.S. Frenk, J.G. Meeder, F.H.M. van Osch, A.L. Bruinen, M.J.W. Janssen, A.W.J.V. Hof, B.M. Rahel*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Background The HEART score is a validated risk stratification tool for chest pain patients presenting to the emergency department and was recently investigated for implementation in a pre-hospital setting. Fingerstick (capillary blood) point-of-care (POC) troponin testing enables quick measurements outside the hospital and seems easier to implement than the current venous blood sampling techniques. This study investigates the diagnostic accuracy of the modified HEART score, integrating fingerstick POC troponin testing, in ruling out acute coronary syndrome (ACS). Methods The data of 96 patients with chest pain, included in a study investigating a novel POC troponin device under development at the cardiac emergency department, were analysed retrospectively. Based on the patients' admission data and capillary POC high-sensitivity troponin I (hs-cTnI) results, the modified HEART score was determined. The outcome measure, for evaluating the diagnostic accuracy of the modified HEART score, was the occurrence of ACS. Results Of the total study population, 33 patients (34%) were diagnosed with ACS. Seventeen patients (18%) were classified as low risk (0-3 points) and one patient (6%) in this group was diagnosed with ACS. The sensitivity and negative predictive value of the modified HEART score was 97.0 and 97.6%, respectively. Conclusion The modified HEART score, integrating capillary POC hs-cTnI results, is a promising tool for ruling out ACS in patients with chest pain presenting to the cardiac emergency department. These results encourage prospective investigation into the integration of fingerstick POC troponin testing in the modified HEART score in a pre-hospital setting.
Original languageEnglish
Pages (from-to)360-369
Number of pages10
JournalNetherlands Heart Journal
Issue number7-8
Early online date24 Nov 2021
Publication statusPublished - Jul 2022


  • Modified HEART score
  • Acute coronary syndrome
  • Point-of-care troponin testing
  • Fingerstick
  • Capillary blood

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