Combined point-of-care biomarkers for risk stratification in patients with non-ST-elevation acute coronary syndrome in the emergency department.

Background: Risk stratification is crucial for patients aged ≥60 years with non-ST-elevation acute coronary syndrome (NSTE-ACS). Although the Global Registry of Acute Coronary Events (GRACE) risk score is commonly used, it may be less practical in the emergency setting. This study aimed to evaluate whether a combined point-of-care testing (CM-POCT) model using three biomarkers could effectively predict major adverse cardiovascular events (MACE). Methods: This retrospective study included 117 patients aged ≥60 years with NSTE-ACS presenting to the emergency department. Point-of-care testing for NT-proBNP, D-dimer, and hs-CRP was performed within 6 h of symptom onset. Independent risk factors were identified, and the predictive value of the three-marker CM-POCT model was compared with the GRACE risk score using receiver operating characteristic curve analysis. Results: Among the 117 participants (mean age 72.2 ± 8.0 years), 27 experienced MACE. Elevated levels of NT-proBNP (≥2,410 pg/mL), D-dimer (≥0.54 µg/mL), and hs-CRP (≥5.58 µg/mL) were each independent predictors of MACE (all Conclusions: The three-marker CM-POCT model could be a more efficient tool for early risk stratification in patients aged ≥60 years with NSTE-ACS in emergency settings. The risk of MACE increases significantly with the number of positive markers.