Table 2

Diagnostic performance of relative change between historical and admission hs-cTnT concentrations for myocardial infarction

Cut-off level (Δ)Sensitivity
(95% CI)
Specificity
(95% CI)
PPV
(95% CI)
NPV
(95% CI)
LR+
(95% CI)
Relative change between historical and admission hs-cTnT
 ROC-optimised cut-off values for MI
  Youden’s J Index85%65.2 [62.7 to 67.7)83.4 [80.3 to 86.6)30.0 [28.4 to 30.7)95.7 [92.1 to 99.4)3.92 [3.78 to 4.08)
  Minimised Euclidean distance of sensitivity and specificity67%70.1 [67.5 to 72.9)77.8 [74.9 to 80.8)25.3 [24.3 to 26.2)96.1 [92.5 to 99.8)3.16 [3.04 to 3.28)
  Min (sensitivity-specificity)59%73.0 [70.3 to 75.9)73.0 [70.3 to 75.9)22.5 [21.6 to 23.3)96.2 [92.6 to 99.9)2.71 [2.61 to 2.81)
  Sensitivity optimised cut-off (≥90%)18%90.0 [86.6 to 93.4)32.3 [31.1 to 33.6)12.4 [12.0 to 12.9)96.8 [93.2 to 100)1.33 [1.28 to 1.38)
  Specificity optimised cut-off (≥90%)125%56.4 [54.3 to 58.6)90.1 [86.7 to 93.6)37.8 [36.4 to 39.2)95.1 [91.5 to 98.8)5.68 [5.46 to 5.90)
Historical hs-cTnT-adjusted admission hs-cTnT
 ROC-optimised cut-off values for MI
  Youden’s J Index23.170.1 [67.4 to 72.8)86.0 [82.8 to 89.4)34.9 [33.6 to 36.3)96.4 [92.8 to 100)5.02 [4.83 to 5.22)
  Minimised Euclidean distance of sensitivity and specificity15.375.1 [72.3 to 78.1)80.3 [77.4 to 83.4)29.0 [27.9 to 30.1)96.8 [93.2 to 100)3.81 [3.67 to 3.96)
  Min (sensitivity-specificity)13.177.3 [74.4 to 80.3)77.1 [74.2 to 80.1)26.5 [25.5 to 27.5)96.9 [93.3 to 100)3.38 [3.25 to 3.51)
  Sensitivity optimised cut-off (≥90%)4.4890.1 [86.7 to 93.6)52.4 [50.4 to 54.4)16.8 [16.2 to 17.5)98.0 [94.4 to 100)1.89 [1.82 to 1.97)
  Specificity optimised cut-off (≥90%)34.663.9 [61.5 to 66.4)90.0 [86.6 to 93.5)40.6 [39.1 to 42.2)95.9 [92.3 to 99.6)6.39 [6.15 to 6.64)
  • hs-cTnT, high-sensitivity cardiac troponin T; LR+, positive likelihood ratio; NPV, negative predictive value; PPV, positive predictive value.