| Endpoint . | 30-day MI or death . | Index NSTEMI . | ||||||
|---|---|---|---|---|---|---|---|---|
| Algorithm . | Roche TnT 0 h < 5 ng/L . | Abbott TnI 0 h < 4 ng/L . | Siemens TnI 0 h < 3 ng/L . | Siemens TnI 0 h < 5 ng/L . | Roche TnT 0 h < 5 ng/L . | Abbott TnI 0 h < 4 ng/L . | Siemens TnI 0 h < 3 ng/L . | Siemens TnI 0 h < 5 ng/L . |
| Derivation cohort | ||||||||
| Sensitivity | 98.4 (95.8–99.5) | 95.9 (92.6–98.0) | 99.2 (97.1–99.9) | 98.8 (96.4–99.7) | 98.7 (96.3–99.7) | 96.1 (92.8–98.2) | 99.6 (97.6–100) | 99.1 (96.9–99.9) |
| NPV | 99.3 (98.2–99.8) | 99.0 (98.3–99.5) | 99.5 (98.3–99.9) | 99.7 (99.0–99.9) | 99.5 (98.5–99.9) | 99.1 (98.4–99.6) | 99.8 (98.7–100) | 99.8 (99.2–100) |
| Specificity | 34.1 (31.8–36.4) | 63.2 (60.8–65.6) | 25.9 (23.8–28.1) | 52.1 (49.6–54.5) | 33.9 (31.6–36.2) | 62.9 (60.5–65.2) | 25.8 (23.7–27.9) | 51.8 (49.3–54.2) |
| PPV | 18.0 (16.0–20.2) | 27.8 (24.8–30.9) | 16.5 (14.6–18.5) | 23.3 (20.7–26.0) | 17.3 (15.3–19.4) | 26.6 (23.6–29.7) | 15.8 (13.9–17.7) | 22.3 (19.8–25.0) |
| % Ruled out | 29.9 | 55.6 | 22.7 | 45.5 | 29.9 | 55.6 | 22.7 | 45.5 |
| False negatives | 4 | 10 | 2 | 3 | 3 | 9 | 1 | 2 |
| Synthetic validation cohort | ||||||||
| Sensitivity | 98.6 (98.5–98.7) | 96.5 (96.4–96.6) | 98.6 (98.5–98.6) | 98.1 (98.0–98.2) | 98.6 (98.5–98.7) | 96.5 (96.4–96.6) | 99.5 (99.5–99.6) | 98.8 (98.8–98.9) |
| NPV | 99.4 (99.4–99.5) | 99.2 (99.2–99.3) | 99.2 (99.2–99.2) | 99.5 (99.4–99.5) | 99.4 (99.4–99.5) | 99.2 (99.2–99.3) | 99.7 (99.7–99.8) | 99.7 (99.7–99.7) |
| Specificity | 33.9 (33.8–34.0) | 63.1 (63.0–63.3) | 26.0 (25.9–26.0) | 51.9 (51.8–52.0) | 33.9 (33.8–34.0) | 63.1 (63.0–63.3) | 25.8 (25.7–25.9) | 51.7 (51.6–51.8) |
| PPV | 17.3 (17.2–17.4) | 26.8 (26.7–27.0) | 16.4 (16.3–16.5) | 23.1 (23.0–23.2) | 17.3 (17.2–17.4) | 26.8 (26.7–27.0) | 15.8 (15.7–15.9) | 22.3 (22.2–22.4) |
| % Ruled out | 29.9 | 55.8 | 22.8 | 45.5 | 29.9 | 55.8 | 22.7 | 45.5 |
| Endpoint . | 30-day MI or death . | Index NSTEMI . | ||||||
|---|---|---|---|---|---|---|---|---|
| Algorithm . | Roche TnT 0 h < 5 ng/L . | Abbott TnI 0 h < 4 ng/L . | Siemens TnI 0 h < 3 ng/L . | Siemens TnI 0 h < 5 ng/L . | Roche TnT 0 h < 5 ng/L . | Abbott TnI 0 h < 4 ng/L . | Siemens TnI 0 h < 3 ng/L . | Siemens TnI 0 h < 5 ng/L . |
| Derivation cohort | ||||||||
| Sensitivity | 98.4 (95.8–99.5) | 95.9 (92.6–98.0) | 99.2 (97.1–99.9) | 98.8 (96.4–99.7) | 98.7 (96.3–99.7) | 96.1 (92.8–98.2) | 99.6 (97.6–100) | 99.1 (96.9–99.9) |
| NPV | 99.3 (98.2–99.8) | 99.0 (98.3–99.5) | 99.5 (98.3–99.9) | 99.7 (99.0–99.9) | 99.5 (98.5–99.9) | 99.1 (98.4–99.6) | 99.8 (98.7–100) | 99.8 (99.2–100) |
| Specificity | 34.1 (31.8–36.4) | 63.2 (60.8–65.6) | 25.9 (23.8–28.1) | 52.1 (49.6–54.5) | 33.9 (31.6–36.2) | 62.9 (60.5–65.2) | 25.8 (23.7–27.9) | 51.8 (49.3–54.2) |
| PPV | 18.0 (16.0–20.2) | 27.8 (24.8–30.9) | 16.5 (14.6–18.5) | 23.3 (20.7–26.0) | 17.3 (15.3–19.4) | 26.6 (23.6–29.7) | 15.8 (13.9–17.7) | 22.3 (19.8–25.0) |
| % Ruled out | 29.9 | 55.6 | 22.7 | 45.5 | 29.9 | 55.6 | 22.7 | 45.5 |
| False negatives | 4 | 10 | 2 | 3 | 3 | 9 | 1 | 2 |
| Synthetic validation cohort | ||||||||
| Sensitivity | 98.6 (98.5–98.7) | 96.5 (96.4–96.6) | 98.6 (98.5–98.6) | 98.1 (98.0–98.2) | 98.6 (98.5–98.7) | 96.5 (96.4–96.6) | 99.5 (99.5–99.6) | 98.8 (98.8–98.9) |
| NPV | 99.4 (99.4–99.5) | 99.2 (99.2–99.3) | 99.2 (99.2–99.2) | 99.5 (99.4–99.5) | 99.4 (99.4–99.5) | 99.2 (99.2–99.3) | 99.7 (99.7–99.8) | 99.7 (99.7–99.7) |
| Specificity | 33.9 (33.8–34.0) | 63.1 (63.0–63.3) | 26.0 (25.9–26.0) | 51.9 (51.8–52.0) | 33.9 (33.8–34.0) | 63.1 (63.0–63.3) | 25.8 (25.7–25.9) | 51.7 (51.6–51.8) |
| PPV | 17.3 (17.2–17.4) | 26.8 (26.7–27.0) | 16.4 (16.3–16.5) | 23.1 (23.0–23.2) | 17.3 (17.2–17.4) | 26.8 (26.7–27.0) | 15.8 (15.7–15.9) | 22.3 (22.2–22.4) |
| % Ruled out | 29.9 | 55.8 | 22.8 | 45.5 | 29.9 | 55.8 | 22.7 | 45.5 |
Diagnostic performance for early rule-out by selected single-sample algorithms.
MI, myocardial infarction; NPV, negative predictive value; NSTEMI, non-ST-elevation myocardial infarction; PPV, positive predictive value; TnI, troponin I; TnT, troponin T.
| Endpoint . | 30-day MI or death . | Index NSTEMI . | ||||||
|---|---|---|---|---|---|---|---|---|
| Algorithm . | Roche TnT 0 h < 5 ng/L . | Abbott TnI 0 h < 4 ng/L . | Siemens TnI 0 h < 3 ng/L . | Siemens TnI 0 h < 5 ng/L . | Roche TnT 0 h < 5 ng/L . | Abbott TnI 0 h < 4 ng/L . | Siemens TnI 0 h < 3 ng/L . | Siemens TnI 0 h < 5 ng/L . |
| Derivation cohort | ||||||||
| Sensitivity | 98.4 (95.8–99.5) | 95.9 (92.6–98.0) | 99.2 (97.1–99.9) | 98.8 (96.4–99.7) | 98.7 (96.3–99.7) | 96.1 (92.8–98.2) | 99.6 (97.6–100) | 99.1 (96.9–99.9) |
| NPV | 99.3 (98.2–99.8) | 99.0 (98.3–99.5) | 99.5 (98.3–99.9) | 99.7 (99.0–99.9) | 99.5 (98.5–99.9) | 99.1 (98.4–99.6) | 99.8 (98.7–100) | 99.8 (99.2–100) |
| Specificity | 34.1 (31.8–36.4) | 63.2 (60.8–65.6) | 25.9 (23.8–28.1) | 52.1 (49.6–54.5) | 33.9 (31.6–36.2) | 62.9 (60.5–65.2) | 25.8 (23.7–27.9) | 51.8 (49.3–54.2) |
| PPV | 18.0 (16.0–20.2) | 27.8 (24.8–30.9) | 16.5 (14.6–18.5) | 23.3 (20.7–26.0) | 17.3 (15.3–19.4) | 26.6 (23.6–29.7) | 15.8 (13.9–17.7) | 22.3 (19.8–25.0) |
| % Ruled out | 29.9 | 55.6 | 22.7 | 45.5 | 29.9 | 55.6 | 22.7 | 45.5 |
| False negatives | 4 | 10 | 2 | 3 | 3 | 9 | 1 | 2 |
| Synthetic validation cohort | ||||||||
| Sensitivity | 98.6 (98.5–98.7) | 96.5 (96.4–96.6) | 98.6 (98.5–98.6) | 98.1 (98.0–98.2) | 98.6 (98.5–98.7) | 96.5 (96.4–96.6) | 99.5 (99.5–99.6) | 98.8 (98.8–98.9) |
| NPV | 99.4 (99.4–99.5) | 99.2 (99.2–99.3) | 99.2 (99.2–99.2) | 99.5 (99.4–99.5) | 99.4 (99.4–99.5) | 99.2 (99.2–99.3) | 99.7 (99.7–99.8) | 99.7 (99.7–99.7) |
| Specificity | 33.9 (33.8–34.0) | 63.1 (63.0–63.3) | 26.0 (25.9–26.0) | 51.9 (51.8–52.0) | 33.9 (33.8–34.0) | 63.1 (63.0–63.3) | 25.8 (25.7–25.9) | 51.7 (51.6–51.8) |
| PPV | 17.3 (17.2–17.4) | 26.8 (26.7–27.0) | 16.4 (16.3–16.5) | 23.1 (23.0–23.2) | 17.3 (17.2–17.4) | 26.8 (26.7–27.0) | 15.8 (15.7–15.9) | 22.3 (22.2–22.4) |
| % Ruled out | 29.9 | 55.8 | 22.8 | 45.5 | 29.9 | 55.8 | 22.7 | 45.5 |
| Endpoint . | 30-day MI or death . | Index NSTEMI . | ||||||
|---|---|---|---|---|---|---|---|---|
| Algorithm . | Roche TnT 0 h < 5 ng/L . | Abbott TnI 0 h < 4 ng/L . | Siemens TnI 0 h < 3 ng/L . | Siemens TnI 0 h < 5 ng/L . | Roche TnT 0 h < 5 ng/L . | Abbott TnI 0 h < 4 ng/L . | Siemens TnI 0 h < 3 ng/L . | Siemens TnI 0 h < 5 ng/L . |
| Derivation cohort | ||||||||
| Sensitivity | 98.4 (95.8–99.5) | 95.9 (92.6–98.0) | 99.2 (97.1–99.9) | 98.8 (96.4–99.7) | 98.7 (96.3–99.7) | 96.1 (92.8–98.2) | 99.6 (97.6–100) | 99.1 (96.9–99.9) |
| NPV | 99.3 (98.2–99.8) | 99.0 (98.3–99.5) | 99.5 (98.3–99.9) | 99.7 (99.0–99.9) | 99.5 (98.5–99.9) | 99.1 (98.4–99.6) | 99.8 (98.7–100) | 99.8 (99.2–100) |
| Specificity | 34.1 (31.8–36.4) | 63.2 (60.8–65.6) | 25.9 (23.8–28.1) | 52.1 (49.6–54.5) | 33.9 (31.6–36.2) | 62.9 (60.5–65.2) | 25.8 (23.7–27.9) | 51.8 (49.3–54.2) |
| PPV | 18.0 (16.0–20.2) | 27.8 (24.8–30.9) | 16.5 (14.6–18.5) | 23.3 (20.7–26.0) | 17.3 (15.3–19.4) | 26.6 (23.6–29.7) | 15.8 (13.9–17.7) | 22.3 (19.8–25.0) |
| % Ruled out | 29.9 | 55.6 | 22.7 | 45.5 | 29.9 | 55.6 | 22.7 | 45.5 |
| False negatives | 4 | 10 | 2 | 3 | 3 | 9 | 1 | 2 |
| Synthetic validation cohort | ||||||||
| Sensitivity | 98.6 (98.5–98.7) | 96.5 (96.4–96.6) | 98.6 (98.5–98.6) | 98.1 (98.0–98.2) | 98.6 (98.5–98.7) | 96.5 (96.4–96.6) | 99.5 (99.5–99.6) | 98.8 (98.8–98.9) |
| NPV | 99.4 (99.4–99.5) | 99.2 (99.2–99.3) | 99.2 (99.2–99.2) | 99.5 (99.4–99.5) | 99.4 (99.4–99.5) | 99.2 (99.2–99.3) | 99.7 (99.7–99.8) | 99.7 (99.7–99.7) |
| Specificity | 33.9 (33.8–34.0) | 63.1 (63.0–63.3) | 26.0 (25.9–26.0) | 51.9 (51.8–52.0) | 33.9 (33.8–34.0) | 63.1 (63.0–63.3) | 25.8 (25.7–25.9) | 51.7 (51.6–51.8) |
| PPV | 17.3 (17.2–17.4) | 26.8 (26.7–27.0) | 16.4 (16.3–16.5) | 23.1 (23.0–23.2) | 17.3 (17.2–17.4) | 26.8 (26.7–27.0) | 15.8 (15.7–15.9) | 22.3 (22.2–22.4) |
| % Ruled out | 29.9 | 55.8 | 22.8 | 45.5 | 29.9 | 55.8 | 22.7 | 45.5 |
Diagnostic performance for early rule-out by selected single-sample algorithms.
MI, myocardial infarction; NPV, negative predictive value; NSTEMI, non-ST-elevation myocardial infarction; PPV, positive predictive value; TnI, troponin I; TnT, troponin T.
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