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 Index | 85% | 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 specificity | 67% | 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 Index | 23.1 | 70.1 [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 specificity | 15.3 | 75.1 [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) | 13.1 | 77.3 [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%) | 4.48 | 90.1 [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%) | 34.6 | 63.9 [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.