Table 2.
Diagnostic performance of hs-cTnT in patients with severe CKD.
| Hs-cTnT Cutoff (ng/L) | Sensitivity (95% CI) |
Specificity (95% CI) |
PPV (95% CI) |
NPV (95% CI) |
Multiples of the 99 Percentile | Multiples of CKD vs. Control | |
|---|---|---|---|---|---|---|---|
| 0 h | |||||||
| 99th percentile a | 14 | 98 (95–99) | 10 (2–19) | 79 (74–85) | 50 (19–81) | - | - |
| ROC optimized | 55 | 83 (77–88) | 65 (52–77) | 89 (85–94) | 52 (39–64) | 3.9 | 4.0 |
| Sensitivity ≥ 90% | 37 | 90 (85–94) | 48 (35–63) | 86 (81–91) | 57 (30–64) | 2.6 | 2.7 |
| Specificity ≥ 80% | 95 | 70 (63–77) | 80 (68–91) | 92 (88–97) | 43 (33–53) | 6.8 | 7.0 |
| Peak prior to angiography | |||||||
| ROC optimized | 95 | 84 (79–90) | 78 (66–89) | 93 (89–97) | 59 (46–70) | 6.8 | 3.8 |
| Sensitivity ≥ 90% | 71 | 90 (86–95) | 60 (45–73) | 89 (84–93) | 63 (49–77) | 5.0 | 2.8 |
| Specificity ≥ 80% | 112 | 79 (73–85) | 82 (71–92) | 94 (90–98) | 53 (41–64) | 8.0 | 4.5 |
| 0 h + |∆0 h–3 h| | |||||||
| 0 h ≥ 55 ng/L or | 98 (91–100) | 55 (25–82) | 93 (83–97) | 86 (42–99) | |||
| 3 h-change ≥ 4 ng/L | |||||||
Depicted are the results of the ROC analysis of hs-cTnT at presentation and peak prior to angiography in patients with severe CKD (eGFR < 30 mL/min/1.73 m2) compared to the controls with normal renal function and the 99th percentile. The discrimination increases when combining the ROC optimized cutoff values for hs-cTnT at presentation and absolute 3 h changes. eGFR, estimated glomerular filtration rate according to the CKD-EPI creatinine equation; hs-cTnT, high-sensitivity cardiac troponin T; NPV, negative predictive value; PPV, positive predictive value; ROC, receiver operating characteristic curve. a 99th percentile of the upper reference limit refers to the conventional assay-specific cutoff for the diagnosis of AMI in healthy individuals, as recommended in clinical practice guidelines.