Point-of-care high-sensitivity cardiac troponin in suspected acute myocardial infarction assessed at baseline and 2 h
Authors' conclusion
A 2-h algorithm using a POC hs-cTnI concentration enables safe and efficient risk assessment of patients with suspected AMI.
Study context
- Population
- Adult emergency patients with suspected acute myocardial infarction (AMI); Point-of-care (POC) high-sensitivity cardiac troponin I (hs-cTnI) (Siemens Atellica® VTLi) at admission and 2 h
- Participants
- 1,486 vs 1,796
- Comparison
- Derivation vs Validation
- Derivationn = 1,486
- Validationn = 1,796
- Outcome
- Index AMI (Types 1 and 2)
Methodological detailstwo international, multi-centre, prospective, observational studies, derivation and validation cohorts, Adjudicated final diagnoses used the hs-cTn assay in clinical use, Primary safety outcome: 30-day MACE (AMI and cardiac death); no results reported
- Two international, multi-centre, prospective, observational studies
- Derivation and validation cohorts
- Adjudicated final diagnoses used the hs-cTn assay in clinical use
- Primary safety outcome: 30-day MACE (AMI and cardiac death); no results reported
Performance
As reported in the abstract
Index AMI, 2-h POC hs-cTnI algorithm
| Test or model | Value | Low risk | Sensitivity (low risk) | NPV (low risk) | High risk | Specificity (high risk) | PPV (high risk) |
|---|---|---|---|---|---|---|---|
| Derivation | 5.5% | 66.1% | 98.8% (95% CI 89.3%-99.9%) | 99.9 (95% CI 99.2%-100%) | |||
| Validation | 4.9% | 53.3% | 98.9% (95% CI 92.4%-99.8%) | 99.9% (95% CI 99.3%-100%) | 5.4% | 98.5% (95% CI 96.6%-99.4%) | 74.5% (95% CI 62.7%-83.6%) |
Value
Derivation5.5%
Validation4.9%
Low risk
Derivation66.1%
Validation53.3%
Sensitivity (low risk)
Derivation98.8% (95% CI 89.3%-99.9%)
Validation98.9% (95% CI 92.4%-99.8%)
NPV (low risk)
Derivation99.9 (95% CI 99.2%-100%)
Validation99.9% (95% CI 99.3%-100%)
High risk
DerivationNot reported in the abstract
Validation5.4%
Specificity (high risk)
DerivationNot reported in the abstract
Validation98.5% (95% CI 96.6%-99.4%)
PPV (high risk)
DerivationNot reported in the abstract
Validation74.5% (95% CI 62.7%-83.6%)
Original publication
Point-of-care high-sensitivity cardiac troponin in suspected acute myocardial infarction assessed at baseline and 2 h. Eur Heart J. Published 6 June 2024. doi:10.
Summarised from the published abstract; every number is checked against it