High-sensitivity versus conventional troponin in the emergency department for the diagnosis of acute myocardial infarction

Table 3 Diagnostic accuracy of HScTnT compared to that of cTnI for the diagnosis of AMI according to pretest probability^a

Patient characteristics	Sensitivity	Specificity	PPV	NPV	Acc	LR⁺	LR^-
All patients (N = 317)
Positive cTnI	71 (55-84)	97 (94 to 98)	78 (62 to 89)	95 (92 to 97)	93 (90 to 96)	21.5 (20.1 to 22.9)	0.32 (0.23 to 0.36)
Positive HScTnT	93 (89 to 100)*	82 (77 to 87)*	47 (36 to 58)*	99 (96 to 100)	84 (79 to 88)*	5.3 (4.8 to 5.8)	0.08 (0.04 to 0.12)
Low to moderate PTP group (n = 258)
Positive cTnI	77 (54 to 92)	97 (94 to 99)	71 (49 to 87)	98 (95 to 99)	95 (92 to 97)	26.1 (24.0 to 28.1)	0.23 (0.17 to 0.30)
Positive HScTnT	91 (69 to 98)	85 (79 to 89)*	36 (24 to 49)**	99 (96 to 100)	85 (80 to 89)*	6.0 (5.3 to 6.6)	0.11 (0.06 to 0.15)
High PTP group (n = 59)
Positive cTnI	65 (43 to 83)	94 (79 to 99)	88 (62 to 98)	81 (65 to 91)*	83 (71 to 91)**	11.7 (10.1 to 13.4)	0.37 (0.18 to 0.55)
Positive HScTnT	96 (76 to 100)***	67 (49 to 81)***	65 (47 to 81)	96 (78 to 100)	78 (65 to 87)	2.9 (2.3 to 3.4)	0.07 (0 to 0.17)

^aHScTnT, highly sensitive cardiac troponin T; PPV: positive predictive value; NPV: negative predictive value; Acc: diagnostic accuracy; LR: likelihood ratio. Values are expressed as percentages (except for LR) and their 95% confidence intervall. Positive cTnI > 0.14 μg/L in Pitie-Salpetriere and Ccochin, > 0.06 μg/L in Bicetre; positive HScTnT >0.014 μg/mL. *P < 0.05 versus positive cTnI in all patients; **P < 0.05 versus cTnI in low to moderate PTP group; ***P < 0.05 versus cTnI in high PTP group.

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