Table 2.
Performance of a modified ESC algorithm and a historical-hs-cTnT algorithm with the use of a historical hs-cTnT value as the 0-hour value to rule out MI
| No of eligible patients | 8432 (100) | |
| MI ≤30 days after the index visit, n (%) | 84 (1.0) | |
|
Algorithm using hs-cTnT measured at the same visit (modified ESC algorithm) | ||
| Total no of patients ruled-out, n (%) | TN (%) | FN (%) |
| 8100 (96) | 8065 (99.6) | 35 (0.4) |
| Total no of patients not ruled-out, n (%) | TP (%) | FP (%) |
| 332 (3.9) | 49 (15) | 283 (85) |
| Rule-out | ||
| No of events, (%) | 35 (0.4) | |
| 30-day risk of MI (95% CI) | 0.4% (0.3% to 0.6%) | |
| NPV, % (95% CI) | 99.6 (99.4 to 99.7) | |
| LR− (95% CI) | 0.43 (0.27 to 0.55) | |
| Sensitivity, % (95% CI) | 58.3 (47.1 to 68.8) | |
|
Algorithm using a historical hs-cTnT value as the 0-hour hs-cTnT value (historical-hs-cTnT algorithm) | ||
| Total no of patients ruled-out, n (%) | TN (%) | FN (%) |
| 6700 (80) | 6664 (99.5) | 36 (0.5) |
| Total no of patients not ruled-out, n (%) | TP (%) | FP (%) |
| 1732 (20) | 48 (2.8) | 1684 (97) |
| Rule-out | ||
| No of events, (%) | 36 (0.5) | |
| 30-day risk of MI (95% CI) | 0.5% (0.4% to 0.8%) | |
| NPV, % (95% CI) | 99.5 (99.2 to 99.6) | |
| LR− (95% CI) | 0.54 (0.34 to 0.68) | |
| Sensitivity, % (95% CI) | 57.1 (45.9 to 67.7) | |
ESC, European Society of Cardiology; FN, false negative; FP, false positive; hs-cTN, high-sensitivity cardiac troponin; LR−, negative likelihood ratio; MI, myocardial infarction; NPV, negative predictive value; TN, true negative; TP, true positive.