Diagnostic value of high sensitive troponin T in chest pain patients with no persistent ST-elevations

Figures & data

Table I. Baseline characteristics (n = 233).

Variables	All n = 233 n (%)	MI n = 114 n (%)	No MI n = 119 n (%)	p-value
Age (median, 25th–75th perc.)	65 (55–76)	72 (60–79)	61 (51–70)	<0.001
Men	155 (67)	81 (71)	74 (62)	0.152
Hypertension	117 (50)	63 (55)	54 (45)	0.131
Diabetes Mellitus	53 (23)	32 (28)	21 (18)	0.058
Current smoker	40 (17)	17 (15)	23 (19)	0.372
Previous cardiovascular disease
Myocardial infarction	70 (30)	31 (27)	39 (33)	0.353
Heart Failure	20 (9)	10 (9)	10 (8)	0.920
Revascularization	49 (21)	17 (15)	32 (27)	0.025
Stroke	14 (6)	9 (8)	5 (4)	0.236
Time from onset of symptoms (median, 25th–75th perc.)	5.3 (3.3–7.5)	5.7 (3.6–8.0)	5.0 (3.0–7.0)	0.018
ECG on admission
Rhythm
Sinus rhythm	198 (85)	90 (79)	10 (91)	0.012
Atrial fibrillation	24 (10)	19 (17)	85 (4)	0.002
ST-depression ≥0.05 mV	99 (43)	71 (62)	28 (24)	<0.001
Left bundle branch block	11 (5)	4 (4)	7 (6)	0.393

MI, myocardial infarction; perc., percentile.

Table II. Diagnostic value of the tested assays to detect myocardial infarction and acute myocardial damage according to conventional troponins.

Time	Method	Cut-off	Sensitivity	Specificity	PPV	NPV
Myocardial infarction according to conventional troponins
0 h	Hs-TnT	≥14 ng/l	97	74	78	97
	TnT	≥0.01 μg/l	95	82	83	94
		≥0.04 μg/l	79	94	93	82
	TnI	≥0.04 μg/l	95	80	82	94
		≥0.06 μg/l	90	92	92	91
2 h	Hs-TnT	≥14 ng/l	99	71	77	99
	TnT	≥0.01 μg/l	99	79	82	99
		≥0.04 μg/l	88	92	92	88
	TnI	≥0.04 μg/l	99	71	77	99
		≥0.06 μg/l	96	89	89	96
Acute myocardial damage according to conventional troponins
0 h	Hs-TnT	≥14 ng/l	97	76	81	97
	TnT	≥0.01 μg/l	95	85	87	94
		≥0.04 μg/l	79	96	96	82
	TnI	≥0.04 μg/l	95	83	85	94
		≥0.06 μg/l	90	95	94	90
2 h	Hs-TnT	≥14 ng/l	99	73	80	99
	TnT	≥0.01 μg/l	99	82	85	99
		≥0.04 μg/l	87	95	94	87
	TnI	≥0.04 μg/l	99	74	80	99
		≥0.06 μg/l	96	91	92	95

Table III. Area under Receiver Operating Curve (ROC) for the tested troponin assays to detect myocardial infarction and acute myocardial damage according to conventional troponins.

	Hs-TnT		Conventional TnT		Accu-TnI
	AUC	(95% CI)	AUC	(95% CI)	AUC	(95% CI)
Myocardial infarction according to conventional troponins
0 h	0.95	(0.92–0.98)	0.93	(0.89–0.97)	0.94	(0.90–0.97)
2 h	0.96	(0.94–0.99)	0.96	(0.93–0.98)	0.97	(0.94–0.99)
Acute myocardial damage according to conventional troponins
0 h	0.97	(0.94–0.99)	0.95	(0.92–0.98)	0.96	(0.92–0.99)
2 h	0.98	(0.96–0.99)	0.97	(0.95–0.99)	0.98	(0.96–1.00)

Hs-TnT, High sensitive troponin T; AUC, Area under curve.

Table IV. Diagnostic value of the tested assays to detect myocardial infarction and acute myocardial damage according to Hs-TnT.

Time	Method	Cut-off	Sensitivity	Specificity	PPV	NPV
Myocardial infarction according to Hs-TnT
0 h	Hs-TnT	≥14 ng/l	98	82	90	95
	TnT	≥0.01 μg/l	90	84	91	83
		≥0.04 μg/l	70	91	93	64
	TnI	≥0.04 μg/l	88	82	90	81
		≥0.06 μg/l	80	92	94	73
2 h	Hs-TnT	≥14 ng/l	100	79	89	100
	TnT	≥0.01 μg/l	95	83	91	90
		≥0.04 μg/l	77	89	93	70
	TnI	≥0.04 μg/l	93	76	87	87
		≥0.06 μg/l	86	91	94	79
Acute myocardial damage according to Hs-TnT
0 h	Hs-TnT	≥14 ng/l	97	85	92	94
	TnT	≥0.01 μg/l	89	88	93	82
		≥0.04 μg/l	70	94	96	63
	TnI	≥0.04 μg/l	88	85	91	79
		≥0.06 μg/l	79	96	97	72
2 h	Hs-TnT	≥14 ng/l	100	84	92	100
	TnT	≥0.01 μg/l	95	88	93	90
		≥0.04 μg/l	78	94	96	70
	TnI	≥0.04 μg/l	93	81	90	87
		≥0.06 μg/l	87	96	97	79

Table V. Area under Receiver Operating Curve (ROC) for the tested troponin assays to detect myocardial infarction and acute myocardial damage according to Hs-TnT.

	Hs-TnT		Conventional TnT		Accu-TnI
	AUC	(95% CI)	AUC	(95% CI)	AUC	(95% CI)
Myocardial infarction according to Hs-TnT
0 h	0.93	(0.89–0.97)	0.89	(0.84–0.94)	0.89	(0.84–0.94)
2 h	0.94	(0.90–0.98)	0.91	(0.87–0.96)	0.92	(0.87–0.96)
Acute myocardial damage according to Hs-TnT
0 h	0.95	(0.92–0.98)	0.91	(0.87–0.95)	0.91	(0.87–0.96)
2 h	0.97	(0.94–0.99)	0.94	(0.91–0.98)	0.94	(0.91–0.98)

Hs-TnT: High sensitive troponin T, AUC: Area under curve.