Table 1.
Comparative sensitivity and specificity of HFABP versus troponin by time of symptom onset in evaluation of acute chest pain.
| First author, year. (End-point) | Population (N) | Plasma cut-off (ng/ml) |
Time to s/s onset | HFABP |
Tn |
HFABP + Tn |
||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sens. (NPV) % | Spec. (PPV)% | AUC | Sens. (NPV)% | Spec. (PPV)% | AUC | Sens. (NPV) % | Spec (PPV) % | |||||
| Tn | HFABP | |||||||||||
| Haastrup, 2000 [15] | Typical CP (130) | 0.5 | 8 | 2.3 (0–6) h | 76 (95) | 83 (46) | NR | 33 (88) | 96 (64) | NR | NR | NR |
| 1.0 | 12 | 76 (95) | 96 (80) | 19 (86) | 98 (67) | |||||||
| NSTEMI = 12.3% | 2.0 | 15 | 62 (93) | 97 (81) | 19 (86) | 99 (80) | ||||||
| Seino, 2003 [16] (AMI) | CP + Non-diagnostic EKG (371) | NR (TnT) | 6.2 | <2 h | 89 (80) | 52 (69) | 0.72 | 22 (50) | 94 (80) | NR | NR | NR |
| AMI= 49% | 2–4 h | 96 (91) | 45 (68) | 0.84 | 57 (65) | 70 (91) | NR | |||||
| 4–6 h | 100 (100) | 40 (57) | 0.96 | 67 (71) | 66 (61) | |||||||
| 6–12 h | 97 (97) | 55 (55) | NR | 94 (95) | 68 (62) | |||||||
| 12–24 h | 95 (90) | 53 (70) | NR | 95 (92) | 65 (76) | |||||||
| Seino, 2004 [17] (AMI) | CP+↑ST or ↑Tn (129) | NR (TnT) | 6.2 | <3 h | 100 (100) | 63 (44.4) | NR | 50 (86.7) | 96.3 (80) | NR | NR | NR |
| AMI = 24% | 3–6 h | 75 (93.8) | 93.8 (75) | 0 (78.9) | 93.8 (0) | NR | ||||||
| 6–12 h | 100 (100) | 72.7 (62.5) | 60 (84.6) | 100 (100) | ||||||||
| >12 h | 100 (100) | 75 (62.5) | 100 (100) | 87.5 (76) | ||||||||
| Ruzgar, 2006 [18] (ACS) | Patients with ACS (40) | 0.01 (TnT) | 6.2 | <6 h | 95.2 | 100 | NR | 38.1 | 100 | NR | NR | NR |
| STEMI = 52% | 6–24 h | 91 | 100 | 100 | 100 | NR | ||||||
| NSTEMI= 30% | ||||||||||||
| Cavus, 2006 [19] (ACS) | Typical CP < 1 hour (67) | 0.1 (TnT) | 7 | <1 h | 97.6 | 38.5 | NR | 100 | 23.1 | NR | NR | NR |
| STEMI = 27% NSTEMI = 10% |
4 h | 97.6 | 88.5 | 100 | 88.5 | NR | ||||||
| McCann, 2008 [20] (AMI) | Ischaemic CP (415) | 0.03 (TnT) | 5 | <4 h | 73 (73) | 71 (71) | 0.77 | 55 (68) | 95 (92) | 0.78 | 85 (83) | 69 (73) |
| STEMI = 18% NSTEMI = 30% |
≥4 h | 78 (75) | 56 (61) | 0.74 (all) | 88 (90) | 94 (92) | 0.88 (all) | 98 (97) | 55 (66) | |||
| Valle, 2008 [21] (AMI + ACS) | Suspected ACS (419) | NR (TnT) | 7 | 74 ± 51 min | 60 (80) | 88 (72) | NR | 19 (69) | 99 (97) | NR | NR | NR |
| AMI = 35% | ||||||||||||
| Orak, 2010 [22] (ACS) | Sudden CP + dyspnea/syncope/nausea / vomiting <6 h duration (83) | 0.01 (TnI) | 2 | <3 h | 100 | 75 | 0.967 (<6h) | 100 | 20 | 0.556 | NR | NR |
| 3–6 h | 97 | 68 | 75 | 21 | (<6 h) | NR | ||||||
| STEMI = 58% NSTEMI = 6% |
<6 h (all) | 98 | 71 | 77 | 20 | |||||||
| Haltern, 2010 [23] (AMI) | Ischaemic-type CP (94) | 0.03 (TnT) | 7.3 | <4 h | 86 (92) | 66 (50) | 0.76 (<4h) | 42 (81) | 100 (100) | 0.71(<4h) | 93 (96) | 66 (52) |
| STEMI = 12% | >4 h | 59 (72) | 64 (50) | 0.71 (all) | 100 (100) | 100 (100) | 0.87(all) | 100 (100) | 64 (63) | |||
| NSTEMI = 16% | NR | |||||||||||
| Kim, 2010 [24] (AMI) | CP suggesting AMI (117) | 0.1 (TnT) | 19 | <2 h | 60 | 77.4 (all) | 0.78 (all) | 20.2 | 98.1 (all) | 0.82 (all) | 33.3 | NR |
| 2–4 h | 64.7 | 17.7 | 82.4 | NR | ||||||||
| AMI-55% | 4–6 h | 91.7 | 58.3 | 91.7 | ||||||||
| 6–12 h | 88.9 | 66.7 | 80 | |||||||||
| McMahon, 2012 [25] (AMI) | CP considered cardiac (1128) | 0.37 (TnI) | 5.24 | <3 h | 64.3 (93) | 84.2 (43) | 0.84 | 50 (92) | 93.3 (60) | 0.76 | 71.4 (94) | |
| AMI = 10% | 3–6 h | 85.3 (97) | 88.7 (55) | 0.89 | 67.6 (95) | 94.3 (66) | 0.85 | 88.2 (98) | ||||
| 6–12 h | 89.9 (98) | 93.5 (70) | 0.94 | 81 (97) | 94.2 (70) | 0.90 | 92.4 (99) | |||||
| 12–24 h | 90.1 (99) | 91.4 (56) | 0.97 | 95.8 (99) | 94.3 (71) | 0.98 | NR (100) | |||||
| Garcia-Valdecasas, 2011 [26] (AMI) | Ischaemic CP within 6 h (165) | 0.6 (TnI) | 6.2 | <3 h | 81 (82) | 53 (52) | 0.73 | 6 (61) | 98 (67) | 0.66 | NR | NR |
| AMI = 40% | <6 h | 81 (80) | 50 (52) | 0.72 | 25 (65) | 91 (64) | 0.66 | NR | ||||
| Aldous, 2012 [27] (AMI) | CP s/o AMI w/o STEMI | 0.028 (TnI) | 60 | ≤4 h | 50 (90.7) | 89.8 (47.6) | NR | 85 (95.1) | 94.7 (81) | NR | 86.7 (97.2) | 87 (55.3) |
| NSTEMI = 15.6% | ||||||||||||
| Gerede, 2015 [28] (AMI) | Ischaemic-type CP >30 min duration (48) | 0.04 (TnI) | 7 | <3 h | 89 (86) | 100 (100) | NR | 33 (50) | 100 (100) | NR | NR | NR |
| NSTEMI = 50% | 3–6 h | 70 (73) | 89(88) | 70 (67) | 67 (70) | NR | ||||||
| >6 h | 100 (100) | 89 (83) | 100 (100) | 89 (83) | ||||||||
| Vupputuri, 2015 [29] (AMI) | CP suggestive of ischaemia (77) | 0.14 (TnI) | 6.4 | ≤6 h | 100 (100) | 85.7 (88.2) | NR | 46.1 (63.6) | 100 (100) | NR | NR | NR |
| AMI > 50% | >6 h | 78.6 (62.5) | 45.5 (64.7) | 78.6 (78.6) | 100 (100) | |||||||
Time to symptom onset reported as Mean (SD) or Median (IQR), as applicable. NPV and PPV were calculated in case of Seino 2003 using published raw data.
AM: Acute myocardial infarction; ACS: acute coronary syndrome; CP: Chest pain; NSTEMI: non ST-elevation myocardial infarction; s/o-symptoms of; STEMI: ST-elevation myocardial infarction; NR: not reported.