Using higher cut-off values to diagnose acute myocardial infarction in patients with elevated hs-cTnT
Tian Wu
Jiaqi Chai
Chunyue Tan
Zhiwen Tao
Hui Yong
Zhenyu Lin
Xiaoxuan Gong
Kun Liu
Lei Xu
Qin Wang
Shenqi Jing
Jiani Xu
Hui Zhou
Tao Li
Liang Yuan
Bo Chen
Fang Wang
Ruxing Wang
Yun Liu
Chunjian Li
Abstract：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.
Keywords：acute myocardial infarctionhigh sensitivity cardiac troponin TelectrocardiogramST-segment elevation myocardial infarctionrenal dysfunction
Publication Date：2025-11-30
Online Publishing Date：2026-01-15(First online date of this platform, not the publication date of the document)
Pages：11( 564-573,中插3-中插5 )