Key result
A dynamic change ≥20% in hs-cTnT improved diagnostic specificity for AMI from 79.8% to 94.2% but did not predict 1-year adverse events (HR 1.1; 95% CI 0.7-1.7).
Why the study?
Does the addition of a dynamic change (δ) ≥20% to hs-cTnT ≥99th percentile improve diagnostic and prognostic performance for acute myocardial infarction in patients with suspected acute coronary syndrome?
Observational (n=939)
Does the addition of a dynamic change (δ) ≥20% to hs-cTnT ≥99th percentile improve diagnostic and prognostic performance for acute myocardial infarction in patients with suspected acute coronary syndrome?
Hazard Ratio: 1.1 (95% CI 0.7–1.7)
Incorporating a dynamic change criterion of ≥20% to hs-cTnT ≥99th percentile improves diagnostic specificity for AMI but significantly reduces sensitivity, and does not improve medium-term risk stratification.
No takes yet. Share an insight, caveat, or question.
May support higher AMI diagnostic specificity in suspected ACS; hypothesis-generating for prognosis and should not yet change practice.
Aldous et al. (2011) conducted an observational in Acute coronary syndrome (without ST elevation) (n=939). Dynamic change (δ) ≥20% in hs-cTnT vs. hs-cTnT ≥99th percentile alone was evaluated on 1-year adverse events (composite of death, AMI, revascularization) (HR 1.1, 95% CI 0.7-1.7). A dynamic change ≥20% in hs-cTnT improved diagnostic specificity for AMI from 79.8% to 94.2% but did not predict 1-year adverse events (HR 1.1; 95% CI 0.7-1.7).
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