Prehospital risk stratification in suspected non-ST-segment elevation acute coronary syndrome with point-of-care troponin: an individual patient data meta-analysis.
HeartSep 11, 2026 (epub)
Jesse Demandt, Dennis Sagel, Cyril Camaro et al.
✦ AI-curated · Sources linked
In 30 seconds
This meta-analysis evaluated the safety of low-risk stratification for suspected non-ST-elevation acute coronary syndrome (NSTE-ACS) patients in the prehospital setting using clinical risk scores (CRS) and point-of-care troponin. Analyzing data from 5,239 patients across six studies, the HEART score demonstrated a sensitivity of 93.2% and a negative predictive value (NPV) of 99.8% for all-cause mortality within 30 days.
Key findings
- The HEART score predicted all-cause mortality with a sensitivity of 93.2% and NPV of 99.8%.
- For mortality and/or acute myocardial infarction, sensitivity was 91.8% and NPV was 97.3%.
- The HEART score also showed a sensitivity of 92.8% and NPV of 97.2% for major adverse cardiac events.
Why it matters
Accurate prehospital risk stratification for NSTE-ACS can enhance patient management and outcomes. High sensitivity and NPV indicate that low-risk patients can be safely identified, potentially reducing unnecessary hospital admissions.