Cardiac arrest & resuscitation
Cardiac troponin for the diagnosis of acute myocardial infarction in patients after out-of-hospital cardiac arrest
Authors' conclusion
cTn has insufficient diagnostic value for AMI in OHCA patients. Use of cTn to establish the cause of OHCA results in overdiagnosis of AMI.
Study context
- Population
- Out-of-hospital cardiac arrest (OHCA) patients who survived to discharge
- Participants
- 618 patients
- Comparison
- Cardiac troponin vs hospital-record diagnosis of acute myocardial infarction (AMI)
- ST-elevation MI (STEMI)n = 179
- Non-ST elevation MI (NSTEMI)n = 77
- No AMIn = 362reference
- Outcome
- Diagnostic value of cTn (hs-TnT, troponin I (TnI)) to diagnose AMI
Performance
As reported in the abstract
Diagnosis of any AMI by first hs-TnT
| Test or model | Sensitivity | Specificity | PPV | NPV |
|---|---|---|---|---|
| Rule in any AMI | — not stated in the abstract | 74 % (95 % CI 69-79) | 60 % (95 % CI 53-68) | — not stated in the abstract |
| Rule out any AMI | 95 % (95 % CI 92-98) | — not stated in the abstract | — not stated in the abstract | 83 % (95 % CI 72-94) |
Sensitivity
Rule in any AMI— not stated in the abstract
Rule out any AMI95 % (95 % CI 92-98)
Specificity
Rule in any AMI74 % (95 % CI 69-79)
Rule out any AMI— not stated in the abstract
PPV
Rule in any AMI60 % (95 % CI 53-68)
Rule out any AMI— not stated in the abstract
NPV
Rule in any AMI— not stated in the abstract
Rule out any AMI83 % (95 % CI 72-94)
— not stated in the abstract
- AUC, STEMI vs no AMI
- 0.772 (95 % CI 0.721-0.824)
- AUC, NSTEMI vs no AMI
- 0.657 (95 % CI 0.575-0.740)
- AUC, STEMI vs NSTEMI
- 0.649 (95 % CI 0.561-0.738)
Further findings
| Outcome | P value |
|---|---|
| First hs-TnTSTEMI vs NSTEMI · significant difference | P ≤ 0.001 |
| First hs-TnTNSTEMI vs No AMI · significant difference | P = 0.013 |
Correlates of peak High-sensitivity troponin T (hs-TnT) in patients without AMI
- Number of shocks significantly correlated
- P < 0.001
- Time until return of spontaneous circulation significantly correlated
- P < 0.001
Original publication
Cardiac troponin for the diagnosis of acute myocardial infarction in patients after out-of-hospital cardiac arrest. Resuscitation. Published 15 August 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →