Table 2

Summary statistics of the suggested National Institute for Health and Care Excellence algorithm according to high-sensitivity troponin assay and Thrombolysis In Myocardial Infarction (TIMI) score threshold

Hs-cTnTHs-cTnI
TIMI score 0 2×2MACENo MACEMACENo MACE
 Test positive: hs-cTn>LoD or TIMI>037422194403140
 Test negative (rule-out): hs-cTn≤LoD and TIMI=025645947
Sensitivity (95% CI)99.5% (98.1% to 99.9%)98.9% (97.4% to 99.6%)
Meta-estimate of sensitivity (95% CI)98.7% (96.5% to 99.6)98.5% (95.4% to 99.5%)
Negative predictive value (95% CI)99.6% (98.7% to 100%)99.5% (98.8% to 99.8%)
Specificity (95% CI)20.3% (18.8% to 21.8%)23.2% (21.9% to 24.5%)
Positive predictive value (95% CI)14.4% (13.1% to 15.8%)12.3% (11.2% to 13.4%)
Proportion of patients potentially suitable for early discharge (95% CI)17.9% (16.6% to 19.3%)21.0% (19.9% to 22.2%)
TIMI score≤1 2×2MACENo MACEMACENo MACE
 Test positive: hs-cTn>LoD or TIMI>137219004382477
 Test negative (rule-out): hs-cTn≤LoD and TIMI≤1488371610
Sensitivity (95% CI)98.9% (97.3% to 99.7%)98.4% (96.8% to 99.4%)
Meta-estimate of sensitivity (95% CI)98.4% (95.7% to 99.4%)98.2% (94.5% to 99.4%)
Negative predictive value (95% CI)99.5% (98.8% to 99.9%)99.6% (99.1% to 99.8%)
Specificity (95% CI)31.7% (30.0% to 33.5%)39.4% (37.9% to 40.9%)
Positive predictive value (95% CI)16.4% (14.9% to 18.0%)15.0% (13.7% to 16.4%)
Proportion of patients potentially suitable for early discharge (95% CI)28.1% (26.5% to 29.7%)35.7% (34.3% to 37.1%)
TIMI score≤2 2×2MACENo MACEMACENo MACE
 Test positive: hs-cTn>LoD or TIMI>236917364332216
 Test negative (rule-out): hs-cTn≤LoD and TIMI≤271047121871
Sensitivity (95% CI)98.1% (96.2% to 99.2%)97.3% (95.3% to 98.6%)
Meta-estimate of sensitivity (95% CI)97.4% (94.7% to 98.8%)97.7% (92.4% to 99.3%)
Negative predictive value (95% CI)99.3% (98.6% to 99.7%)99.4% (98.9% to 99.7%)
Specificity (95% CI)37.6% (35.8% to 39.5%)45.8% (44.2% to 47.3%)
Positive predictive value (95% CI)17.5% (15.9% to 19.2%)16.3% (15.0% to 17.8%)
Proportion of patients potentially suitable for early discharge (95% CI)33.4% (31.7% to 35.0%)40.5% (39.0% to 41.9%)
  • MACE, major adverse cardiac event; Hs-cTn: high-sensitivity cardiac troponin T or I; TIMI, thrombolysis inmyocardial infarction.