Performance of the clinical chemistry score versus hs-cTnI concentration (measured using the Ortho Vitros 3600 hs-cTnI assay) alone for identifying risk for 30-day MACE
| Score cut-off | Patients with at least 1 MACE within 30 d | Patients with no MACE within 30 d |
|---|---|---|
| CCS ≥ 1, no. of patients | 204 | 744 |
| CCS < 1, no. of patients | 1* | 109 |
| Sensitivity, % (95% CI) | 99.5 (97.3–99.9) | |
| Negative predictive value, % (95% CI) | 99.1 (93.9–99.9) | |
| Negative likelihood ratio (95% CI) | 0.04 (0.01–0.27) | |
| Specificity, % (95% CI) | 12.8 (10.6–15.2) | |
| Positive predictive value, % (95% CI) | 21.5 (21.1–21.9) | |
| Positive likelihood ratio (95% CI) | 1.14 (1.11–1.17) | |
| hs-cTnI ≥ 1 ng/L, no. of patients | 187 | 519 |
| hs-cTnI < 1 ng/L, no. of patients | 18 | 334 |
| Sensitivity, % (95% CI) | 91.2 (86.5–94.7) | |
| Negative predictive value, % (95% CI) | 94.9 (92.2–96.7) | |
| Negative likelihood ratio (95% CI) | 0.22 (0.14–0.35) | |
| Specificity, % (95% CI) | 39.2 (35.9–42.5) | |
| Positive predictive value, % (95% CI) | 26.5 (25.2–27.8) | |
| Positive likelihood ratio (95% CI) | 1.50 (1.40–1.61) | |
| hs-cTnI ≥ 5 ng/L, no. of patients | 152 | 183 |
| hs-cTnI < 5 ng/L, no. of patients | 53 | 669 |
| Sensitivity, % (95% CI) | 74.2 (67.6–80.0) | |
| Negative predictive value, % (95% CI) | 92.7 (90.9–94.1) | |
| Negative likelihood ratio (95% CI) | 0.33 (0.26–0.42) | |
| Specificity, % (95% CI) | 78.5 (75.6–81.2) | |
| Positive predictive value, % (95% CI) | 45.4 (41.6–49.1) | |
| Positive likelihood ratio (95% CI) | 3.45 (2.97–4.02) | |
| CCS = 5, no. of patients | 58 | 19 |
| CCS < 5, no. of patients | 147 | 834 |
| Specificity, % (95% CI) | 97.8 (96.5–98.7) | |
| Positive predictive value, % (95% CI) | 75.3 (65.0–83.4) | |
| Positive likelihood ratio (95% CI) | 12.7 (7.74–20.8) | |
| Sensitivity, % (95% CI) | 28.3 (22.2–34.9) | |
| Negative predictive value, % (95% CI) | 85.0 (83.9–86.1) | |
| Negative likelihood ratio (95% CI) | 0.73 (0.67–0.80) | |
| hs-cTnI > 11 ng/L, no. of patients | 132 | 84 |
| hs-cTnI ≤ 11 ng/L, no. of patients | 73 | 768 |
| Specificity, % (95% CI) | 90.1 (87.9–92.0) | |
| Positive predictive value, % (95% CI) | 61.1 (55.6–66.4) | |
| Positive likelihood ratio (95% CI) | 6.5 (5.2–8.2) | |
| Sensitivity, % (95% CI) | 64.4 (57.4–70.9) | |
| Negative predictive value, % (95% CI) | 91.3 (89.7–92.7) | |
| Negative likelihood ratio (95% CI) | 0.39 (0.33–0.47) |
Note: CCS = clinical chemistry score, CI = confidence interval, hs-cTNI = high-sensitivity cardiac troponin I, hs-cTNT = high-sensitivity cardiac troponin T, MACE = major adverse cardiac event.
↵* At presentation, this patient had the following values: hs-TnI < 1 ng/L with the Ortho assay, hs-cTnI < 2 ng/L with the Abbott assay and hs-cTnT < 3 ng/L with the Roche assay. The patient’s 30-day outcome was coronary artery bypass grafting.