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-TnT
hs-TnTwith mHS
hs-TnT with copeptin and mHS
Sensitivity
99.3%
99.1%
100%
95% CI (%)
88–97.9
94.8–100
96.6–100
NPV
85.4%
94.4%
100%
95% CI (%)
70.8–94.4
72.2–99.9
75.3–100
Test accuracy
134/154 (87%)
121/154 (78%)
118/154 (77%)
value
<0.001
<0.001
<0.001
(b)
AMI/death at 30 days
hs-TnT
hs-TnT with mHS
hs-TnT with copeptin† and mHS
Sensitivity
94.3%
99.1%
100%
95% CI (%)
88.1–97.9
94.9–100
96.6–100
NPV
85.4%
94.4%
100%
95% CI (%)
70.8–94.4
72.7–99.9
75.3–100
Test accuracy
135/154 (88%)
122/154 (79%)
119/154 (77%)
value
<0.001
<0.001
<0.001
(c)
AMI/death at one year
hs-TnT
hs-TnT with mHS
hs-TnT with copeptin and mHS
Sensitivity
92.2%
99%
100%
95% CI (%)
85.1–96.6
94.7–100
96.5–100
NPV
80.5%
94.4%
100%
95% CI (%)
65.1–91.2
72.7–99.9
75.3–100
Test accuracy
127/147 (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.