Defining a reference population to determine the 99th percentile of a contemporary sensitive cardiac troponin I assay

International Journal of Cardiology
Till KellerKarl J Lackner

Abstract

Diagnosis of acute myocardial infarction (AMI) according to the universal definition is based on ischemic symptoms, imaging findings and elevated myocardial necrosis markers, preferably cardiac troponin I/T with diagnostic threshold representing the 99th percentile of a reference population. It is not clearly defined if this should be an unselected population-based or a healthy cohort with respect to cardiac diseases. Aim of the current study was to describe the distribution of troponin I using a sensitive assay and to evaluate the impact of cardiac diseases and cardiovascular risk factors in apparently healthy individuals. Troponin I was determined using a contemporary sensitive assay (TnI Ultra, Siemens) with 10% coefficient of variation (0.03 ng/mL) below the published 99th percentile (0.04 ng/mL) in 5000 participants (49.2% female) of the Gutenberg Health Study, a community-based, prospective, observational single-center cohort study. The calculated 99 th percentile cut-offs were tested in 1818 patients with suspected AMI. Troponin I concentration representing the 99th percentile of the overall study population was 0.04 ng/mL. Excluding individuals with prevalent cardiovascular disease lowers the 99th percentile to 0.034 ng...Continue Reading

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Citations

Apr 11, 2013·Clinica Chimica Acta; International Journal of Clinical Chemistry·Tar-Choon AwShiow-Pin Tan
Feb 4, 2014·Clinical Research in Cardiology : Official Journal of the German Cardiac Society·Christoph SinningChristine Espinola-Klein
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Feb 18, 2014·Journal of the American College of Cardiology·M Odette GoreJames A de Lemos
Oct 19, 2016·Clinica Chimica Acta; International Journal of Clinical Chemistry·Magdalena KrintusGrazyna Sypniewska
Nov 9, 2016·Clinica Chimica Acta; International Journal of Clinical Chemistry·Dae-Hyun KoWon-Ki Min
Jan 17, 2016·European Heart Journal. Acute Cardiovascular Care·Niklas SchoferStefan Blankenberg
Jun 5, 2019·Biomarkers : Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals·Beatrice von JeinsenTill Keller
Aug 5, 2017·PloS One·Stergios TzikasTill Keller
Jun 11, 2017·Clinical Chemistry and Laboratory Medicine : CCLM·Aldo ClericoUNKNOWN on the behalf of the Study Group on Cardiovascular Risk Biomarkers of the Italian Society of Clinical Biochemistry (SIBioC)
Jul 13, 2013·Clinical Chemistry and Laboratory Medicine : CCLM·Astrid PetersmannMatthias Nauck
Apr 5, 2020·Nature Communications·Wei XuKun Qian
Jan 9, 2015·Annals of Clinical Biochemistry·Gareth C McKeeman, Peter W Auld

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