Research Article

Combined Use of High-Sensitive Cardiac Troponin, Copeptin, and the Modified HEART Score for Rapid Evaluation of Chest Pain Patients

Table 4

Performance of baseline combination of hs-TnT, copeptin, and the mHS for the diagnosis of AMI and short-term prognosis.
(a)

Diagnosis of AMI
hs-TnThs-TnTwith mHShs-TnT with copeptin and mHS

Sensitivity99.3%99.1%100%
95% CI (%)88–97.994.8–10096.6–100
NPV85.4%94.4%100%
95% CI (%)70.8–94.472.2–99.975.3–100
Test accuracy134/154 (87%)121/154 (78%)118/154 (77%)
value<0.001<0.001<0.001

(b)

AMI/death at 30 days
hs-TnThs-TnT with mHShs-TnT with copeptin and mHS

Sensitivity94.3%99.1%100%
95% CI (%)88.1–97.994.9–10096.6–100
NPV85.4%94.4%100%
95% CI (%)70.8–94.472.7–99.975.3–100
Test accuracy135/154 (88%)122/154 (79%)119/154 (77%)
value<0.001<0.001<0.001

(c)

AMI/death at one year
hs-TnThs-TnT with mHShs-TnT with copeptin and mHS

Sensitivity92.2%99%100%
95% CI (%)85.1–96.694.7–10096.5–100
NPV80.5%94.4%100%
95% CI (%)65.1–91.272.7–99.975.3–100
Test accuracy127/147 (82%)118/147 (80%)115/147 (75%)
value<0.001<0.001<0.001

Data are presented as median (25th–75th percentile) or (%). hs-TnT: high-sensitivity troponin T; mHS: modified HEART score; AMI: acute myocardial infarction; CI: confidence interval; NPV: negative predictive value. Baseline hs-TnT rule out at 14 ng/l. mHS rule out at ≤3. Baseline copeptin rule out at 17.4 pmol/l.