TABLE 3.
Diagnostic performance of hs‐cTnI.
| n (%) | hs‐cTnI ≥ 45 ng/L, n (%) | Sensitivity (95% CI) | Specifity (95% CI) | NPV (95% CI) | PPV (95% CI) | |
|---|---|---|---|---|---|---|
| TTE LVEF < 52% | 24 (68.6) | 8 (33) | 33.3 (16–55) | 81.8 (48–98) | 36 (27–46) | 80 (50–94) |
| cMRI LVEF < 52% | 8 (22.9) | 2 (25) | 25 (3–65) | 81.8 (48–98) | 60 (48–71) | 50 (15–85) |
| TTE LVEF < 52% and ECG abnormalities | 27 (77.1) | 8 (29.6) | 29.6 (14–50) | 75 (35–97) | 24 (17–36) | 80 (51–94) |
| TTE or cMRI LVEF < 52% and LGE | 29 (82.3) | 9 (31) | 33.3 (16–55) | 81.8 (48–98) | 36 (27–46) | 80 (50–94) |
| TTE or cMRI LVEF < 52% or LGE and ECG abnormalities | 30 (85.7) | 9 (30) | 30 (15–49) | 80 (28–100) | 16 (10–24) | 90 (59–98) |
| Cardiac involvement a | 34 (97.1) | 10 (29.4) | 29.4 (15–48) | 100 (3–100) | 4 (3–5) | 100 |
Abbreviations: CI, confidence interval; cMRI, cardiac magnetic resonance imaging; ECG, electrocardiogram; hs‐cTnI, high‐sensitivity cardiac troponin I; LGE, late gadolinium enhancement; LVEF, left ventricular ejection fraction; NPV, negative predictive value; PPV, positive predictive value; TTE, transthoracic echocardiography.
Cardiac involvement requires meeting following criteria: reduced LVEF or presence of LGE on contrast‐enhanced MRI, ventricular morphological abnormalities on TTE or cMRI, diastolic dysfunction evidence, pathological myocardial biopsy findings, abnormal ECG, rhythm disorders, conduction abnormalities, arterial hypertension, or coronary vessel disease. Reduced LVEF is assessed via cMRI or, if not possible, through TTE.