Diagnostic Performance of a Combination Biomarker Algorithm for Rule-Out of Acute Myocardial Infarction at Time of Presentation to theEmergency Department, Using Heart-Type Fatty Acid-Binding Protein andHigh-Sensitivity Troponin T tests

Navarro-Paredes, Cesar; Kurth, Mary Jo; Lamont, John; Menown, IB; Ruddock, MW; Fitzgerald, S.; McLaughlin, James

doi:10.4172/2155-9880.1000600

Cited by 2 publications

(6 citation statements)

References 16 publications

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“…Consecutive patients (age >18 years) with chest pain of presumed ischaemic origin were recruited at Craigavon Area and Daisy Hill hospitals in Northern Ireland between October 2009 and October 2011 [8]. More details about the ethical approval, demographics, biomarkers measured at different time points including hs-cTnT and H-FABP have been previously reported [8].…”

Section: Recruitment Of Patients and Datamentioning

confidence: 99%

“…Reference algorithms A and B were previously reported [8] where the thresholds for hs-cTnT were not explored and left as suggested by the ESC guidelines.…”

Section: Comparisonsmentioning

confidence: 99%

“…The ESC algorithm for presentation (algorithm 5) [11], based only on hs-cTnT, exhibit the maximum possible sensitivity (detecting all the AMI cases without leaving any false negatives) at the expense of admitting and treating 205 out of 288 non-AMI cases, exhibiting a low specificity of 0.288. Our previous algorithm (referred to as algorithm A) combining hs-cTnT and H-FABP used thresholds for hs-cTnT from the ESC guidelines [8]. The specificity was increased to 0.656 at the expense of lowering the sensitivity to 0.958.…”

Section: Comparisonsmentioning

confidence: 99%

“…H-FABP was selected as an optimal biomarker to help hs-cTnT over other biomarkers [7]. The analysis demonstrated that hs-cTnT consistently had a higher Area Under the Receiver Operating characteristic Curve (AUROC) than the other biomarkers but was not statistically different to H-FABP at presentation [8] and at 3 and 6 hours [7]. H-FABP was also a significant predictor of AMI according to logistic regression models [7].…”

Section: Introductionmentioning

confidence: 99%

“…The previous algorithms show thresholds and rules for H-FABP leaving the hs-cTnT thresholds unaltered to those recommended by the European Society of Cardiology (ESC) [8]. This study aimed to explore further hs-cTnT thresholds in combination with H-FABP.…”

Section: Introductionmentioning

confidence: 99%

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An Algorithm Based on Combining hs-cTNT and H-FABP for Ruling Out Acute Myocardial Infarction

Navarro¹,

Kurth²,

Ruddock³

et al. 2019

2019 Computing in Cardiology Conference (CinC)

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Our previous work demonstrated that algorithms combining high sensitivity cardiac troponin T (hs-cTnT) and heart-type fatty acid-binding protein (H-FABP) may help in ruling out Acute Myocardial Infarction (AMI). For those algorithms, the hs-cTnT thresholds were adopted from the ESC guidelines. This time, we present a data-driven approach that also explores hs-cTnT thresholds. The results show a significant improvement when compared to previous algorithms reported. Using a cohort of n = 360 patients (288 Non-AMI and 72 AMI), a ruleout algorithm used at presentation identified more low-risk patients who presented with chest pain of suspected cardiac origin than the standard ESC algorithm: (199/288 (69.1%) vs. 83/288 (28.8%) (p <0.0005)), respectively. According to our data, our algorithm at the emergency department, would identify additional non-AMI patients in comparison to the ESC algorithm, potentially reducing the number of hospital admissions by 42%.

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Section: Recruitment Of Patients and Datamentioning

confidence: 99%

“…Reference algorithms A and B were previously reported [8] where the thresholds for hs-cTnT were not explored and left as suggested by the ESC guidelines.…”

Section: Comparisonsmentioning

confidence: 99%

Section: Comparisonsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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