Table 3.
Metrics for improvement in risk prediction with addition of cardiac troponin T (cTnT)
| Overall | Women | Men | ||||
|---|---|---|---|---|---|---|
| Base model | Base model + cTnT | Base model | Base model + cTnT | Base model | Base model + cTnT | |
| HARD CHD (FATAL CHD + MI)* | ||||||
| Adjusted AUC (95% CI) | 0.710 (0.691, 0.732) | 0.724 (0.708, 0.747) | 0.692 (0.667, 0.725) | 0.718 (0.695, 0.753) | 0.688 (0.663, 0.720) | 0.701 (0.679, 0.735) |
| Difference in AUC (95% CI) | 0.014 (0.008, 0.024) | 0.027 (0.014, 0.046) | 0.013 (0.004, 0.028) | |||
| G-B statistic | 7.02 (p=0.64) | 6.78 (p=0.66) | 12.55 (p=0.18) | 12.72 (p=0.18) | 8.51 (p=0.48) | 12.83 (p=0.17) |
| IDI (95% CI) | 0.032 (0.021, 0.048) | 0.043 (0.026, 0.071) | 0.028 (0.015, 0.052) | |||
| NRI (95% CI) | 10.1% (3.8%, 15.9%) | 19.2% (6.7%, 25.2%) | 7.2% (1.6%, 19.1%) | |||
| NRI in intermediate-risk group (95% CI) | 22.4% (13.7%, 33.4%) | 42.0% (20.5%, 57.1%) | 15.2% (6.9%, 29.0%) | |||
| ALL CHD* | ||||||
| Adjusted AUC (95% CI) | 0.715 (0.702, 0.733) | 0.724 (0.711, 0.742) | 0.691 (0.670, 0.719) | 0.704 (0.684, 0.730) | 0.660 (0.643, 0.684) | 0.673 (0.656, 0.699) |
| Difference in AUC (95% CI) | 0.009 (0.005, 0.015) | 0.012 (0.004, 0.024) | 0.013 (0.005, 0.024) | |||
| G-B statistic | 14.24 (p=0.11) | 19.87 (p=0.02) | 17.88 (p=0.04) | 6.49 (p=0.69) | 9.74 (p=0.37) | 14.79 (p=0.10) |
| IDI (95% CI) | 0.021 (0.014, 0.032) | 0.025 (0.014, 0.040) | 0.021 (0.012, 0.037) | |||
| NRI (95% CI) | 4.5% (0.4%, 8.8%) | 6.9% (1.1%, 17.1 %) | 2.0% (−0.5%, 9.6%) | |||
| NRI in intermediate-risk group (95% CI) | 11.7% (6.9%, 17.9%) | 19.8% (9.9%, 32.1%) | 6.9% (2.8%, 14.3%) | |||
| TOTAL MORTALITY† | ||||||
| Adjusted AUC (95% CI) | 0.719 | 0.740 | 0.692 | 0.715 | 0.712 | 0.733 |
| Difference in AUC (95% CI) | 0.021 (0.014, 0.028) | 0.024 (0.014, 0.034) | 0.021 (0.013, 0.031) | |||
| G-B statistic | 11.8 (p=0.23) | 8.8 (p=0.46) | 12.6 (p=0.18) | 8.0 (p=0.53) | 15.9 (p=0.07) | 4.1 (p=0.91) |
| IDI (95% CI) | 0.037 (0.027, 0.047) | 0.035 (0.022, 0.050) | 0.037 (0.025, 0.052) | |||
| NRI (95% CI) | 10.7% (4.3%, 13.1%) | 10.0% (4.2%, 16.9%) | 6.1% (1.4%, 13.0%) | |||
| NRI in intermediate-risk group (95% CI) | 21.4% (14.4%, 25.9%) | 21.0% (13.0%, 29.4%) | 18.5% (9.9%, 26.3%) | |||
| HF HOSPITALIZATION† | ||||||
| Adjusted AUC (95% CI) | 0.749 | 0.777 | 0.741 | 0.769 | 0.736 | 0.772 |
| Difference in AUC (95% CI) | 0.028 (0.019, 0.037) | 0.028 (0.019, 0.042) | 0.036 (0.022, 0.053) | |||
| G-B statistic | 11.5 (p=0.24) | 10.4 (p=0.32) | 10.1 (p=0.34) | 9.1 (p=0.42) | 9.2 (P=0.42) | 2.3 (P=0.99) |
| IDI (95% CI) | 0.044 (0.032, 0.058) | 0.038 (0.023, 0.055) | 0.057 (0.036, 0.085) | |||
| NRI (95% CI) | 15.4% (8.4%, 20.6%) | 16.7% (6.4%, 22.4%) | 15.9% (8.0%, 27%) | |||
| NRI in intermediate-risk group (95% CI) | 30.9% (22.1%, 40.0)% | 31.2% (18.0%, 43.6%) | 30.7% (20.1%, 49.5%) | |||
AUC = area under the receiver operating characteristic curve; G-B statistic = Grønnesby – Borgan goodness-of-fit statistic; IDI = integrated discrimination improvement; NRI = net reclassification improvement
*
Base model for CHD: model based on ARIC Coronary Risk Score (age, gender, race, total cholesterol, HDL-C, systolic blood pressure, use of antihypertensive medications, smoking status, and presence of diabetes defined as fasting blood glucose >126 mg/dL or use of antidiabetic medications).
†
Base model for total mortality and HF: ARIC Coronary Risk Score + BMI + presence of LVH on ECG + serum creatinine.