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Table 2 Performance of H-FABP with hs-cTnI 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 = 255)

No AMI (n = 845)

Total (n = 1100)

Proportion Negative Test (%)

Sensitivity (%)

NPV (%)

Optimal combinationa : ECG positive or hs-cTnI ≥10 ng/L or H-FABP ≥4.3 ng/mL

Positive

246

392

638

 

99.2 (97.1 to 99.8)

 

Negative

2

439

441

40.9

 

99.5 (98.4 to 99.9)

Hs-cTnI 99th percentile threshold: ECG positive or hs-cTnI ≥26 ng/L

Positive

225

122

347

 

90.7 (86.5 to 93.7)

 

Negative

23

709

732

67.8

 

96.9 (95.3 to 97.9)

Hs-cTnI or H-FABP 99th percentile threshold: ECG positive or hs-cTnI ≥26 ng/L or H-FABP ≥ 3.6 ng/mL

Positive

244

442

686

 

98.4 (95.9 to 99.4)

 

Negative

4

389

393

36.4

 

99.0 (97.4 to 99.6)

Hs-cTnI 99th percentile with H-FABP ROC derivedb: ECG positive or hs-cTnI ≥ 26 ng/L or H-FABP ≥ 3.1 ng/mL

Positive

245

511

756

 

98.8 (96.5 to 99.6)

 

Negative

3

320

323

29.9

 

99.1 (97.3 to 99.7)

Hs-cTnI threshold for >99.0 % sensitivity: ECG or hs-cTnI ≥ 3.9 ng/L

Positive

246

456

702

 

99.2 (97.1 to 99.8)

 

Negative

2

375

377

34.9

 

99.5 (98.1 to 99.9)

  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-cTnI and ECG