Performance of the clinical chemistry score versus hs-cTnI concentration (measured using the Abbott Architect i2000 hs-cTnI assay) alone for identifying risk for 90-day MACE in cohort 2
| Score cut-off | Patients with at least 1 MACE within 90 d | Patients with no MACE within 90 d |
|---|---|---|
| CCS ≥ 1, no. of patients | 1092 | 4483 |
| CCS < 1, no. of patients* | 8 | 391 |
| Sensitivity, % (95% CI) | 99.3 (98.6–99.7) | |
| Negative predictive value, % (95% CI) | 98.0 (96.1–99.0) | |
| Negative likelihood ratio (95% CI) | 0.09 (0.05–0.18) | |
| Specificity, % (95% CI) | 8.0 (7.3–8.8) | |
| Positive predictive value, % (95% CI) | 19.6 (19.4–19.7) | |
| Positive likelihood ratio (95% CI) | 1.08 (1.07–1.09) | |
| hs-cTnI ≥ 5 ng/L, no. of patients | 965 | 2635 |
| hs-cTnI < 5 ng/L, no. of patients | 135 | 2239 |
| Sensitivity, % (95% CI) | 87.7 (85.6–89.6) | |
| Negative predictive value, % (95% CI) | 94.3 (93.4–95.1) | |
| Negative likelihood ratio (95% CI) | 0.27 (0.23–0.31) | |
| Specificity, % (95% CI) | 45.9 (44.5–47.3) | |
| Positive predictive value, % (95% CI) | 26.8 (26.1–27.5) | |
| Positive likelihood ratio (95% CI) | 1.62 (1.57–1.68) | |
| CCS = 5, no. of patients | 420 | 488 |
| CCS < 5, no. of patients | 680 | 4386 |
| Specificity, % (95% CI) | 90.0 (89.1–90.8) | |
| Positive predictive value, % (95% CI) | 46.3 (43.5–49.1) | |
| Positive likelihood ratio (95% CI) | 3.81 (3.41–4.27) | |
| Sensitivity, % (95% CI) | 38.2 (35.3–41.1) | |
| Negative predictive value, % (95% CI) | 86.6 (86.0–87.1) | |
| Negative likelihood ratio (95% CI) | 0.69 (0.66–0.72) | |
| hs-cTnI > 26 ng/L, no. of patients | 567 | 709 |
| hs-cTnI ≤ 26 ng/L, no. of patients | 533 | 4165 |
| Specificity, % (95% CI) | 85.5 (84.4–86.4) | |
| Positive predictive value, % (95% CI) | 44.4 (42.2–46.6) | |
| Positive likelihood ratio (95% CI) | 3.54 (3.24–3.87) | |
| Sensitivity, % (95% CI) | 51.6 (48.5–54.5) | |
| Negative predictive value, % (95% CI) | 88.7 (88.0–89.3) | |
| Negative likelihood ratio (95% CI) | 0.57 (0.53–0.60) |
Note: CCS = clinical chemistry score, CI = confidence interval, hs-cTnI = high-sensitivity cardiac troponin I, MACE = major adverse cardiac event.
↵* At 30 d, MACE occurred in ≤ 5 patients with a CCS < 1 and these results cannot be reported per ICES standard operating procedures where counts < 6 are suppressed for privacy reasons.