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Derivation and external validation of a high‐sensitivity cardiac troponin–based proteomic model to predict the presence of obstructive coronary artery disease

Journal of the American Heart Association Aug 23, 2020

McCarthy CP, Neumann JT, Michelhaugh SA, et al. - Researchers intended to develop as well as externally validate a hs‐cTn (high‐sensitivity cardiac troponin)–based proteomic model to detect obstructive coronary artery disease (CAD). They identified predictors of ≥70% coronary stenosis, using a derivation cohort including 636 patients referred for coronary angiography. Incorporating 3 clinical variables (male gender, age, and prior percutaneous coronary intervention) and 3 biomarkers (hs‐cTnI [high‐sensitivity cardiac troponin I], adiponectin, and kidney injury molecule‐1), a model was constructed. A sensitivity of 80%, specificity 71%, positive and negative predictive values of 83% and 66%, respectively, for ≥70% stenosis were afforded by the model at the optimal cutoff. The score showed similarly good performance in the external validation cohort. Overall, findings demonstrated high accuracy of a model including hs‐cTnI for predicting the presence of obstructive CAD including in those with indeterminate hs‐cTnI levels.

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