ArticleJACC. Advances2026
Acute Coronary Syndrome Risk Prediction Using Portable Cable-Free ECG Device Combined With Clinical Risk Assessment.
Article in JACC. Advances, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundPatient uncertainty in symptom interpretation during acute coronary syndrome (ACS) contributes to patient-related presentation delays, increasing morbidity and mortality. Integrating clinical context with electrocardiogram (ECG) analysis in a portable patient-operated ACS risk assessment device may facilitate early self-triage.
objectivesThe objective of the study was to evaluate the diagnostic performance of an algorithm combining pre-existing atherosclerotic cardiovascular risk (PER), symptom risk (SR), and portable ECG recorded using a hand-held cable-free device for ACS risk estimation.
methodsThis prospective single-center study enrolled 212 consecutive emergency department patients with chest pain; 184 patients with complete data were analyzed (96 learning set and 88 test set). Three independent components: PER, SR, and ST-vector loop parameters, derived from a three-lead cable-free credit card-size ECG device were integrated into a hierarchical fusion ACS risk assessment model. In 98 patients, asymptomatic postevent reference portable ECG was obtained 9 to 12 months later. Algorithm performance was evaluated using receiver operating characteristic curve analysis and compared with human consensus interpretation of 12-lead ECG plus PER and SR information.
resultsAlgorithm ACS prediction using a single portable ECG achieved area under the curve of 0.865, increasing to 0.929 with postevent reference comparison (P = 0.036). At matched sensitivity, the model specificity was comparable to the human consensus (false-positive rate 0.527 vs 0.458; P = 0.709) and improved using reference comparison (model false-positive rate 0.198 vs human 0.556; P = 0.004).
conclusionsAn algorithm combining clinical risk factors, symptoms, and ECG recording using hand-held cable-free device provides clinically meaningful ACS risk stratification. If fully integrated into a personal device, it may help support early self-triage decisions and reduce patient-related prehospital delays.
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