Using higher cut-off values to diagnose acute myocardial infarction in patients with elevated hs-cTnT
Tian Wu1
Jiaqi Chai1
Chunyue Tan1
Zhiwen Tao1
Hui Yong1
Zhenyu Lin1
Xiaoxuan Gong1
Kun Liu1
Lei Xu1
Qin Wang1
Shenqi Jing2
Jiani Xu3
Hui Zhou4
Tao Li4
Liang Yuan1
Bo Chen1
Fang Wang1
Ruxing Wang5
Yun Liu6
Chunjian Li1
1.Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China2.Center for Data Management,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China;Department of Medical Informatics,School of Biomedical Engineering and Informatics,Nanjing Medical University,Nanjing,Jiangsu 211166,China;Institute of Medical Informatics and Management,Nanjing Medical University,Nanjing,Jiangsu 211166,China;Jiangsu Province Engineering Research Center of Chronic Disease Big Data Application and Smart Healthcare Service,Nanjing,Jiangsu 210029,China3.Center for Data Management,the First Affiliated Hospital of Nanjing Medical University,Nanjing,Jiangsu 210029,China;Jiangsu Province Engineering Research Center of Chronic Disease Big Data Application and Smart Healthcare Service,Nanjing,Jiangsu 210029,China4.Shanghai Synyi Medical Technology Co.,Ltd.,Shanghai 200000,China5.Department of Cardiology,the Affiliated Wuxi People's Hospital of Nanjing Medical University,Wuxi People's Hospital,Wuxi Medical Center,Nanjing Medical University,Wuxi,Jiangsu 214023,China6.Department of Medical Informatics,School of Biomedical Engineering and Informatics,Nanjing Medical University,Nanjing,Jiangsu 211166,China;Institute of Medical Informatics and Management,Nanjing Medical University,Nanjing,Jiangsu 211166,China
摘要：It is often challenging to diagnose acute myocardial infarction(AMI)in patients with elevated high-sensitivity cardiac troponin T(hs-cTnT)before observing a significant rise and/or fall in hs-cTnT.The current study aimed to identify an optimal cut-off to rule in AMI.A total of 76 411 patients with elevated hs-cTnT were included.The predictive cut-off values for diagnosing ST-segment elevation myocardial infarction(STEMI)and non-ST-segment elevation myocardial infarction(NSTEMI)were assessed using the area under the receiver operating characteristic curve(AUC).Among the patients,50 466(66.0%)had non-cardiac diseases,25 945(34.0%)had cardiac diseases,and 15 502(20.3%)had AMI,including 816(1.1%)with STEMI and 14 686(19.2%)with NSTEMI.The median hs-cTnT level was 3 788.0 ng/L in STEMI patients and 67.2 ng/L in NSTEMI patients.The optimal cut-off for diagnosing STEMI was 251.9 ng/L,with a sensitivity of 90.7%,specificity of 86.5%,and an AUC of 0.942;the optimal cut-off for diagnosing NSTEMI was 130.5 ng/L,with a sensitivity of 40.9%,specificity of 83.8%,and an AUC of 0.638.Collectively,optimizing the cut-off values for diagnosing STEMI and NSTEMI to 251.9 ng/L and 130.5 ng/L,respectively,demonstrated high accuracy in a large cohort of Chinese patients with elevated hs-cTnT.
机标关键词：hs-ctnthigherwithacutediagnoseelevatedinfarctionmyocardial
分类号：R542.2(心脏、血管（循环系）疾病)
论文发表日期：2025-11-30
在线出版日期：2026-01-15（本平台首次上网日期，不代表文献的发表时间）
页数：11( 564-573,中插3-中插5 )
英文信息