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Table 4 Diagnostic performance of relative 3-hour change in troponin I concentration

From: Identification of acute myocardial infarction in patients with atrial fibrillation and chest pain with a contemporary sensitive troponin I assay

  Cut-off Sensitivity Specificity PPV NPV
[%] (95 % CI) (95 % CI) (95 % CI) (95 % CI)
Relative 3-h change in troponin I concentration
n=298, n=54 patients with MI type 1
Absolute 3-h change threshold optimized for:
Sum of sensitivity and specificity 0.3 0.85 (0.73-0.93) 0.80 (0.75-0.85) 0.49 (0.38-0.59) 0.96 (0.92-0.98)
Specificity 40 0.74 (0.60-0.85) 0.88 (0.83-0.92) 0.58 (0.45-0.70) 0.94 (0.90-0.97)
Relative 3-h change in troponin I concentration and troponin I on admission above 99th percentile cut-off
n=66, n=46 patients with MI type 1
Absolute 3-h change threshold optimized for:
Sum of sensitivity and specificity 0.3 0.83 (0.69-0.92) 0.40 (0.19-0.64) 0.76 (0.62-0.87) 0.50 (0.25-0.75)
Specificity 40 0.70 (0.54-0.82) 0.75 (0.51-0.91) 0.86 (0.71-0.95) 0.52 (0.33-0.71)
Relative 3-h change in troponin I concentration and troponin I on admission above unweighted optimized cut-off
n=61, n=44 patients with MI type 1
Absolute 3-h change threshold optimized for:
Sum of sensitivity and specificity 0.3 0.82 (0.67-0.92) 0.47 (0.23-0.72) 0.80 (0.65-0.90) 0.50 (0.25-0.75)
Specificity 40 0.68 (0.52-0.81) 0.88 (0.64-0.99) 0.94 (0.79-0.99) 0.52 (0.33-0.71)
Relative 3-h change in troponin I concentration and troponin I on admission above specificity-optimized cut-off
n=41, n=36 patients with MI type 1
Absolute 3-h change threshold optimized for:
Sum of sensitivity and specificity 0.3 0.78 (0.61-0.90) 0.60 (0.15-0.95) 0.93 (0.78-0.99) 0.27 (0.06-0.61)
Specificity 40 0.61 (0.43-0.77) 1 (0.36-1) 1 (0.78-1) 0.26 (0.09-0.51)
  1. Optimized cut-offs associated with 90 % specificity or with highest sum of sensitivity and specificity were applied as thresholds for absolute and relative 3-hour change in troponin I concentration
  2. Cut-offs applied to troponin I values determined upon admission were derived from the derivation cohort optimized with respect to high specificity or highest sum of sensitivity and specificity as well as the 99th percentile cut-off of the assay used. 95 % CI denotes 95 % confidence interval. MI denotes myocardial infarction