| Outcome: ACS or other life-threatening disease | Outcome: ACS | Outcome: AMI | Outcome: NSTEMI | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Interval, onset complaints to presentation, hours | 0– 24 | 0– 3 | 3– 24 | 0– 24 | 0– 3 | 3– 24 | 0– 24 | 0– 3 | 3– 24 | 0– 24 | 0– 3 | 3– 24 |
| Patients, n | 291a | 106b | 179b | 291a | 106b | 179b | 291a | 106b | 179b | 291a | 106b | 179b |
| Sens H-FABP POCT, % (95% CI) | 25.7 (13.1 to 43.6) | 8.3 (0.44 to 40.2) | 36.4 (18.0 to 59.2) | 25.8 (12.5 to 44.9) | 9.1 (4.8 to 42.9) | 36.8 (17.2 to 61.4) | 26.9 (12.4 to 48.1) | 10.0 (0.52 to 45.9) | 40.0 (17.5 to 67.1) | 18.9 (5.0 to 46.3) | 0 (0 to48.3) | 33.3 (9.0 to 69.1) |
| Spec H-FABP POCT (95% CI) | 97.3 (94.2 to 98.8) | 98.9 (93.4 to 99.9) | 96.2 (91.5 to 98.4) | 96.9 (93.8 to 98.6) | 98.9 (93.4 to 99.9) | 95.6 (90.8 to 98.1) | 96.6 (93.4 to 98.3) | 99.0 (93.5 to 99.9) | 95.1 (90.3 to 97.7) | 95.3 (91.9 to 97.4) | 98.0 (92.3 to 99.7) | 93.5 (88.4 to 96.6) |
| NPV H-FABP POCT, % (95% CI) | 90.5 (86.3 to 93.6) | 9.4 (81.5 to 94.3) | 91.5 (85.9 to 95.1) | 1.6 (87.6 to 94.5) | 90.4 (82.6 to 95.0) | 92.7 (87.4 to 96.0) | 93.1 (89.2 to 95.7) | 91.3 (83.8 to 95.7) | 94.5 (89.6 to 97.3) | 95.3 (91.9 to 97.4) | 94.2 (87.4 to 97.6) | 96.4 (91.9 to 98.5) |
| PPV H-FABP PoCT, % (95% CI) | 56.3 (30.6 to 79.2) | 50.0 (26.7 to 97.3) | 57.1 (29.6 to 81.2) | 50.0 (25.5 to 74.5) | 50.0 (26.7 to 97.3) | 50.0 (24.0 to 76.0) | 43.8 (20.8 to 69.4) | 50.0 (26.7 to 97.3) | 42.9 (18.8 to 70.4) | 18.9 (5.0 to 46.3) | 0 (0 to 80.2) | 21.4 (5.7 to 51.2) |
Sensitivity, specificity, negative and positive predictive values of POC H-FABP for all patients, patients presenting within 3 hours of onset of complaints, and patients presenting 3–24 hours after onset of complaints for several outcomes, namely: (1) life-threatening disease (that is, composite of acute heart failure, pulmonary embolism, aortic dissection, acute death, ACS); (2) ACS (that is, UA, NSTEMI, STEMI); (3) AMI (that is, NSTEMI and STEMI); and (4) NSTEMI only.
a12 test failures among 303 included patients.
b In six cases, patients presented within 24 hours after onset of complaints; however, registration of duration of complaints was incomplete. These patients are not included in the tables representing subgroups of patients presenting with chest pain within 3 hours or 3–24 hours after onset of complaints.
ACS = acute coronary syndrome. AMI = acute myocardial infarction. CI = confidence intervals. H-FABP = heart-type fatty acid-binding protein. NPV = negative predictive value. NSTEMI = non-ST elevated myocardial infarction. POC = point of care. PPV = positive predictive value. Sens = sensitivity. Spec = specificity. STEMI = ST-elevated myocardial infarction. UA = unstable angina.