Table 2.
Summary statistics of the suggested National Institute for Health and Care Excellence algorithm according to high-sensitivity troponin assay and Thrombolysis In Myocardial Infarction (TIMI) score threshold
| Hs-cTnT | Hs-cTnI | |||
| TIMI score 0 2×2 | MACE | No MACE | MACE | No MACE |
| Test positive: hs-cTn>LoD or TIMI>0 | 374 | 2219 | 440 | 3140 |
| Test negative (rule-out): hs-cTn≤LoD and TIMI=0 | 2 | 564 | 5 | 947 |
| Sensitivity (95% CI) | 99.5% (98.1% to 99.9%) | 98.9% (97.4% to 99.6%) | ||
| Meta-estimate of sensitivity (95% CI) | 98.7% (96.5% to 99.6) | 98.5% (95.4% to 99.5%) | ||
| Negative predictive value (95% CI) | 99.6% (98.7% to 100%) | 99.5% (98.8% to 99.8%) | ||
| Specificity (95% CI) | 20.3% (18.8% to 21.8%) | 23.2% (21.9% to 24.5%) | ||
| Positive predictive value (95% CI) | 14.4% (13.1% to 15.8%) | 12.3% (11.2% to 13.4%) | ||
| Proportion of patients potentially suitable for early discharge (95% CI) | 17.9% (16.6% to 19.3%) | 21.0% (19.9% to 22.2%) | ||
| TIMI score≤1 2×2 | MACE | No MACE | MACE | No MACE |
| Test positive: hs-cTn>LoD or TIMI>1 | 372 | 1900 | 438 | 2477 |
| Test negative (rule-out): hs-cTn≤LoD and TIMI≤1 | 4 | 883 | 7 | 1610 |
| Sensitivity (95% CI) | 98.9% (97.3% to 99.7%) | 98.4% (96.8% to 99.4%) | ||
| Meta-estimate of sensitivity (95% CI) | 98.4% (95.7% to 99.4%) | 98.2% (94.5% to 99.4%) | ||
| Negative predictive value (95% CI) | 99.5% (98.8% to 99.9%) | 99.6% (99.1% to 99.8%) | ||
| Specificity (95% CI) | 31.7% (30.0% to 33.5%) | 39.4% (37.9% to 40.9%) | ||
| Positive predictive value (95% CI) | 16.4% (14.9% to 18.0%) | 15.0% (13.7% to 16.4%) | ||
| Proportion of patients potentially suitable for early discharge (95% CI) | 28.1% (26.5% to 29.7%) | 35.7% (34.3% to 37.1%) | ||
| TIMI score≤2 2×2 | MACE | No MACE | MACE | No MACE |
| Test positive: hs-cTn>LoD or TIMI>2 | 369 | 1736 | 433 | 2216 |
| Test negative (rule-out): hs-cTn≤LoD and TIMI≤2 | 7 | 1047 | 12 | 1871 |
| Sensitivity (95% CI) | 98.1% (96.2% to 99.2%) | 97.3% (95.3% to 98.6%) | ||
| Meta-estimate of sensitivity (95% CI) | 97.4% (94.7% to 98.8%) | 97.7% (92.4% to 99.3%) | ||
| Negative predictive value (95% CI) | 99.3% (98.6% to 99.7%) | 99.4% (98.9% to 99.7%) | ||
| Specificity (95% CI) | 37.6% (35.8% to 39.5%) | 45.8% (44.2% to 47.3%) | ||
| Positive predictive value (95% CI) | 17.5% (15.9% to 19.2%) | 16.3% (15.0% to 17.8%) | ||
| Proportion of patients potentially suitable for early discharge (95% CI) | 33.4% (31.7% to 35.0%) | 40.5% (39.0% to 41.9%) | ||
MACE, major adverse cardiac event; Hs-cTn: high-sensitivity cardiac troponin T or I; TIMI, thrombolysis inmyocardial infarction.