Cumulative sensitivity, specificity, pre- and post-test probabilities, positive and negative predictive values (NPV and PPV) of cardiac markers for SCEs at 4, 8, 16, and 24 hours after admission (using all values for each marker to this timepoint)
| Time (hours) | Marker | False negatives (n)4-150 | Sensitivity (95% CI) | Specificity (95% CI) | NPV4-151 (95% CI) | PPV4-152 (95% CI) | Pretest probability4-153 |
|---|---|---|---|---|---|---|---|
| 4 | Myoglobin | 10 | 54.6 (47.1 to 61.8) | 74.4 (67.4 to 80.4) | 92.4 (86.2 to 96.1) | 22.2 (13.1 to 35.2) | 11.8 |
| 8 | Myoglobin | 9 | 65.4 (58.2 to 71.9) | 71.2 (64.2 to 77.3) | 93.1 (86.9 to 96.6) | 25.8 (16.7 to 37.6) | 13.3 |
| 16 | Myoglobin | 8 | 70.4 (63.3 to 76.6) | 69.5 (62.4 to 75.8) | 93.4 (87.1 to 96.9) | 27.5 (18.3 to 39.2) | 14.1 |
| 24 | Myoglobin | 8 | 70.4 (62.8 to 77.0) | 65.3 (57.6 to 72.3) | 92.2 (84.7 to 96.3) | 27.5 (18.3 to 39.2) | 15.8 |
| 4 | CK-MBmass | 4 | 80.0 (73.4 to 85.4) | 92.1 (87.0 to 95.4) | 97.4 (93.2 to 99.2) | 55.2 (37.2 to 71.9) | 10.8 |
| 8 | CK-MBmass | 3 | 88.0 (82.4 to 92.0) | 91.9 (86.9 to 95.1) | 98.1 (94.2 to 99.5) | 61.1 (44.6 to 75.4) | 12.7 |
| 16 | CK-MBmass | 3 | 88.9 (83.3 to 92.8) | 90.6 (85.3 to 94.2) | 98.0 (93.7 to 99.5) | 61.5 (45.6 to 75.3) | 14.4 |
| 24 | CK-MBmass | 3 | 89.3 (83.2 to 93.4) | 87.9 (81.6 to 92.3) | 97.5 (92.3 to 99.3) | 61.0 (45.5 to 74.5) | 17.5 |
| 4 | MLC 1 | 6 | 75.0 (68.1 to 80.9) | 64.2 (56.9 to 71.0) | 94.6 (88.2 to 97.8) | 23.4 (15.2 to 34.1) | 12.7 |
| 8 | MLC 1 | 6 | 78.6 (72.1 to 83.9) | 61.1 (53.9 to 67.8) | 94.6 (88.1 to 97.8) | 24.7 (16.9 to 34.7) | 14.0 |
| 16 | MLC1 | 5 | 81.5 (75.0 to 86.5) | 56.5 (49.2 to 63.5) | 95.0 (88.3 to 98.2) | 22.9 (15.6 to 32.4) | 13.7 |
| 24 | MLC 1 | 5 | 81.5 (75.0 to 86.6) | 52.5 (45.1 to 59.9) | 94.3 (86.6 to 97.9) | 22.7 (15.4 to 32.1) | 14.6 |
| 4 | cTnI | 3 | 87.0 (81.1 to 91.2) | 90.1 (85.0 to 94.0) | 98.0 (93.9 to 99.5) | 55.6 (39.3 to 70.7) | 12.2 |
| 8 | cTnI | 3 | 88.9 (83.5 to 92.7) | 90.1 (84.8 to 93.7) | 98.1 (94.1 to 99.5) | 58.5 (43.1 to 72.4) | 13.6 |
| 16 | cTnI | 3 | 89.3 (83.8 to 93.1) | 88.3 (82.7 to 92.4) | 98.0 (93.7 to 99.5) | 56.8 (42.0 to 70.5) | 14.7 |
| 24 | cTnI | 3 | 89.3 (83.4 to 93.3) | 85.7 (79.3 to 90.5) | 97.6 (92.5 to 99.4) | 55.6 (41.0 to 69.2) | 16.7 |
| 4 | Any marker | 3 | 88.0 (82.4 to 92.1) | 57.7 (50.4 to 64.7) | 97.0 (90.8 to 99.2) | 23.7 (16.1 to 33.3) | 13.0 |
| 8 | Any marker | 2 | 92.9 (88.2 to 95.8) | 54.0 (46.9 to 61.0) | 97.9 (92.0 to 99.6) | 24.5 (17.3 to 33.6) | 13.9 |
| 16 | Any marker | 2 | 92.9 (88.1 to 95.9) | 51.5 (44.3 to 58.5) | 97.8 (91.5 to 99.6) | 23.6 (16.6 to 32.5) | 13.9 |
| 24 | Any marker | 2 | 92.9 (88.0 to 95.9) | 46.6 (39.4 to 54.0) | 97.4 (90.9 to 99.5) | 23.2 (16.3 to 31.9) | 14.8 |
↵4-150 Patients sustaining an SCE despite negative marker concentrations up to and including this timepoint.
↵4-151 Probability of a patient avoiding any SCEs in hospital after a negative test result.
↵4-152 Probability of a patient experiencing an SCE in hospital after a positive test result.
↵4-153 Probability of a patient experiencing an SCE in hospital before applying the results of tests.
Post-test probability (%) of a patient suffering an SCE after a negative test = 100 − NPV.