Key result
The combination of H-FABP < 4.3 ng/mL, hs-cTnI < 10.0 ng/L, and a negative ECG maintained 99.2% sensitivity for acute myocardial infarction while classifying 40.9% of patients as low-risk.
Why the study?
Does the addition of H-FABP to high-sensitivity troponin and ECG at presentation improve the early rule-out of acute myocardial infarction in emergency department patients with chest pain?
Population
1,079 adults presenting acutely to the emergency department with symptoms suggestive of acute myocardial…
Comparison
Measurement of Heart Fatty Acid Binding Protein… vs High-sensitivity troponin and ECG alone without…
Design
Cohort, Cardiologists adjudicating AMI were blinded to hs-cTnI, hs-cTnT, and…
Follow-up
Initial hospital attendance
Authors
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May support early AMI rule-out in ED chest pain; hypothesis-generating and requires prospective validation before practice change.
Cohort (n=1,079)
No
Does the addition of H-FABP to high-sensitivity troponin and ECG at presentation improve the early rule-out of acute myocardial infarction in emergency department patients with chest pain?
The addition of H-FABP to high-sensitivity troponin at presentation can safely rule out acute myocardial infarction in up to 40% of emergency department patients with chest pain, potentially accelerating early discharge.
Young et al. (2016) conducted a cohort in Suspected acute myocardial infarction (n=1,079). H-FABP combined with high-sensitivity troponin I (hs-cTnI) and ECG was evaluated on Sensitivity for acute myocardial infarction during initial hospital attendance (95% CI 97.1-99.8). The combination of H-FABP < 4.3 ng/mL, hs-cTnI < 10.0 ng/L, and a negative ECG maintained 99.2% sensitivity for acute myocardial infarction while classifying 40.9% of patients as low-risk.
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