Background: Accurate diagnosis of acute coronary syndrome (ACS) in a timely fashion is challenging in the elderly\npopulation, especially elderly women, who usually exhibit atypical clinical symptoms. A multiple cardiac biomarker\n(MCB) based approach has been shown to improve diagnostic efficacy of ACS. However, data in various age groups\nand sex differences remain largely unexplored.\nMethods: Point-of-care testing (POCT) was performed on 290 patients (aged ââ?°Â¥18 years) who were admitted to the\nemergency department (ED) with symptoms of acute chest pain under suspicion of acute coronary syndrome (ACS).\nThe MCB approach in current work assessed four cardiac biomarkers: myoglobin, troponin I, creatine kinase-myocardial\nband isoenzyme fraction (CK-MB), and brain natriuretic peptide (BNP).\nResults: Overall, the MCB approach demonstrated considerably higher sensitivity for elderly patients than for younger\npatients in identifying ACS (80.0 % [64.1ââ?¬â??90.0] vs. 52.6 % [37.3ââ?¬â??67.5] for ââ?°Â¥65 years and <65 years groups), with younger\npopulation showed greater specificity (44.1 % [35.3ââ?¬â??53.4] vs. 84.9 % [76.9ââ?¬â??90.5] for ââ?°Â¥65 years and <65 years groups,\nrespectively). The highest sensitivity achieved for elderly women who reported chest pain was 87.5 % [95 % CI: 64ââ?¬â??96.5]).\nIn general, the sensitivity of this approach was higher for female patients than for male patients (80 % [58.4ââ?¬â??91.9] vs. 61 %\n[47.8ââ?¬â??73.0]).\nConclusions: The MCB approach can provide a quick and accurate clinical diagnosis in elderly and female patients, both\nof whom have traditionally proven to be challenging to diagnose from suspected acute coronary syndrome.
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