Derivation and validation of a high sensitivity troponin-T HEART pathway
Authors' conclusion
A novel hs-cTnT HEART Pathway with serial 0- and 1-hour hs-cTnT measures has high NPV and moderate PPV for 30-day cardiac death or MI.
Study context
- Population
- Adult ED patients with symptoms suggestive of ACS, 0- and 1-hour hs-cTnT and HEAR score
- Participants
- 1,452 patients
- Comparison
- hs-cTnT HEART Pathway derivation vs validation
- Derivationn = 729
- Validationn = 723
- Primary endpoint
- Cardiac death or MI
- Follow-up
- 30 days
Methodological detailsmulticentre, 8 United States (US) sites, derivation and validation
- Multicentre
- 8 US sites
- Derivation and validation
Primary result
As reported in the abstract
30-day cardiac death or MI
| Group | Ruled out | NPV | Ruled in | PPV | Events among ruled out |
|---|---|---|---|---|---|
| Derivation | 36.5% (266/729) | 99.2% (95% CI: 98.2-100) | 15.4% (112/729) | 55.4% (95% CI: 46.2-64.6) | |
| Validation | 37.6% (272/723) | 99.3% (95% CI: 98.3-100) | 14.5% (105/723) | 57.1% (95% CI: 47.7-66.6) | 2 |
Ruled out
Derivation36.5% (266/729)
Validation37.6% (272/723)
NPV
Derivation99.2% (95% CI: 98.2-100)
Validation99.3% (95% CI: 98.3-100)
Ruled in
Derivation15.4% (112/729)
Validation14.5% (105/723)
PPV
Derivation55.4% (95% CI: 46.2-64.6)
Validation57.1% (95% CI: 47.7-66.6)
Events among ruled out
Derivation— not stated in the abstract
Validation2
- 30-day cardiac death or myocardial infarction (MI), overall
- 12.7% (184/1452)
Original publication
Derivation and validation of a high sensitivity troponin-T HEART pathway. Am Heart J. Published 16 November 2022. doi:10.
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