Diagnostic performance of different measures of hs-cTnT concentrations for myocardial infarction
| Admission hs-cTnT | Historical hs-cTnT-adjusted admission hs-cTnT | Relative change between historical and admission hs-cTnT | |||||||
| Calibration criterion vs admission hs-cTnT | n/a | Specificity | No. patients ruled-in | Sensitivity | PPV | Specificity | No. patients ruled-in | Sensitivity | PPV |
| Cut-off level | ≥52 ng/L | ≥40.2 | ≥44.4 | ≥75.8 | ≥30.9 | ≥137% | ≥137% | ≥150% | ≥130% |
| Specificity, %(95% CI) | 91.2 (87.8 to 94.7) | 91.2 (87.8 to 94.8) | 91.9 (88.5 to 95.5) | 94.8 (91.2 to 98.5) | 89.1 (85.7 to 92.5) | 91.2 (87.8 to 94.8) | 91.3 (87.9 to 94.9) | 92.5 (89.1 to 96.1) | 90.7 (87.3–94.3) |
| Rule-in, n (%) | 3629 (13) | 3852 (14) | 3631 (13) | 2724 (9.8) | 4499 (16) | 3666 (13) | 3648 (13) | 3287 (12) | 3813 (14) |
| Sensitivity, %(95% CI) | 52.5 (50.6 to 54.6) | 61.1 (58.8 to 63.5) | 59.9 (57.6 to 62.2) | 52.5 (50.6 to 54.6) | 65.3 (62.9 to 67.8) | 54.2 (52.2 to 56.4) | 54.2 (52.1 to 56.3) | 52.3 (50.4 to 54.4) | 55.2 (53.2 to 57.4) |
| PPV, % (95% CI) | 38.9 (37.4 to 40.4) | 42.6 (41.0 to 44.3) | 44.3 (42.6 to 46.0) | 51.8 (49.9 to 53.8) | 39.0 (37.5 to 40.5) | 39.7 (38.3 to 41.3) | 39.9 (38.4 to 41.4) | 42.8 (41.2 to 44.4) | 38.9 (37.5 to 40.4) |
| MI≤30 days, n (%) | 1411 (39) | 1642 (43) | 1608 (44) | 1411 (51) | 1754 (39) | 1457 (40) | 1455 (40) | 1406 (43) | 1484 (39) |
| FP, n (%) | 2218 (61) | 2210 (57) | 2023 (56) | 1313 (49) | 2745 (61) | 2209 (60) | 2193 (60) | 1881 (57) | 2329 (61) |
| Efficacy, % (95% CI) | 87.4 (84.2 to 90.8) | 88.3 (85.0 to 91.7) | 88.8 (85.5 to 92.3) | 90.7 (87.3 to 94.2) | 86.8 (83.5 to 90.2) | 87.6 (84.4 to 91.0) | 87.7 (84.4 to 91.1) | 88.6 (85.3 to 92.1) | 87.3 (84.0 to 90.7) |
| LR+ (95% CI) | 5.95 (5.73 to 6.18) | 6.95 (6.69 to 7.22) | 7.43 (7.16 to 7.72) | 10.1 (9.68 to 10.4) | 5.98 (5.75 to 6.21) | 6.17 (5.94 to 6.41) | 6.21 (6.00 to 6.47) | 6.99 (6.73 to 7.26) | 5.96 (5.74 to 6.19) |
FP, false positives; hs-cTnT, high-sensitivity cardiac troponin T; LR+, positive likelihood ratio; MI, myocardial infarction; NPV, negative predictive value; PPV, positive predictive value.