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Figure 4 The sensitivity, specificity and positive predictive value (PPV) of ST segment elevation or any ST segment T or Q wave or LBBB abnormality for acute myocardial ischemia or infarction are compared between the initial hospital ECG (open bars) and the initial ECG plus serial (prehospital and initial hospital) changes (solid bars). As compared with the initial hospital ECG alone, added consideration of serial changes between the prehospital and initial hospital ECG in these variables significantly improved the sensitivity for acute myocardial ischemia or infarction, at the expense of a reduction in specificity and positive predictive value. Data are shown for 1,254 patients with and 1,411 patients without acute myocardial ischemia or infarction.
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