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Table 4 Performance of H-FABP with hs-cTnT and ECG

From: Heart Fatty Acid Binding Protein and cardiac troponin: development of an optimal rule-out strategy for acute myocardial infarction

Test

 

AMI (n = 251)

No AMI (n = 834)

Total (n = 1085)

Proportion Negative Test (%)

Sensitivity (%)

NPV (%)

Optimal combinationa : ECG positive or hs-cTnT ≥7.6 ng/L or H-FABP ≥3.9 ng/mL

Positive

246

487

733

 

99.2 (97.1 to 99.8)

 

Negative

2

344

346

32.1

 

99.4 (97.9 to 99.8)

Hs-cTnT 99th percentile threshold: ECG positive or hs-cTnT ≥14 ng/L

Positive

235

253

488

 

94.8 (91.2 to 96.9)

 

Negative

13

578

591

54.8

 

97.8 (96.3 to 98.7)

Hs-cTnT or H-FABP 99th percentile threshold: ECG positive or hs-cTnT ≥14 ng/L or H-FABP ≥ 3.6 ng/mL

Positive

241

469

710

 

97.2 (94.3 to 98.6)

 

Negative

7

362

369

34.2

 

98.1 (96.1 to 99.1)

Hs-cTnT 99th percentile with H-FABP ROC derivedb: ECG positive or hs-cTnT ≥ 14 ng/L or H-FABP ≥ 3.0 ng/mL

Positive

243

546

789

 

98.0 (95.4 to 99.1)

 

Negative

5

285

290

26.9

 

98.3 (96.0 to 99.3)

Hs-cTnT threshold for >99.0 % sensitivity: ECG or hs-cTnT ≥ 6.4 ng/L

Positive

247

431

678

 

99.6 (97.8 to 99.9)

 

Negative

1

400

401

37.2

 

99.8 (98.6 to 100.0)

  1. aStrategy that yielded the maximum proportion of low-risk patients whilst maintaining a minimum sensitivity for AMI of 99 %
  2. bH-FABP ROC derived threshold which maximized the combination of sensitivity and specificity in patients negative for hs-cTnT and ECG