Direct comparison of clinical decision limits for cardiac troponin T and I

Heart
Dorien M KimenaiSteven J R Meex

Abstract

The 99th percentile upper reference limit of high-sensitivity cardiac troponin (hs-cTn) from a healthy reference population is used for diagnosing acute myocardial infarction (AMI). Accepted current thresholds of hs-cTnT (Roche) and hs-cTnI (Abbott) are 14 and 26 ng/L, respectively. Since thresholds for hs-cTnT and hs-cTnI were derived from different reference cohorts it is unclear whether they are biologically equivalent. We directly assessed sex-specific and age-specific 99th percentile upper reference limits of hs-cTnT and hs-cTnI in a single reference cohort, to investigate whether current divergent thresholds of hs-cTnT and hs-cTnI stem from intrinsic assay differences or reflect cohort variation. A healthy reference population was derived from a population-based cohort (the Maastricht Study: n=3451; age: 40-75 years). Individuals with diabetes mellitus, a history of cardiovascular disease, cardiac ischaemia on ECG, N-terminal pro-brain natriuretic peptide >125 ng/L or estimated glomerular filtration rate <60 mL/min/1.73 m(2) were excluded. Non-parametric analyses were performed to assess 99th percentile upper reference limits. 1540 individuals were included in the healthy reference population (age 57±8 years, 52.4% women)...Continue Reading

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Citations

Aug 25, 2016·Clinical Biochemistry·Kai M EggersBertil Lindahl
May 2, 2017·Critical Reviews in Clinical Laboratory Sciences·Marek KozinskiGrazyna Sypniewska
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Apr 19, 2021·Clinica Chimica Acta; International Journal of Clinical Chemistry·Vanda Barakett-HamadéGhassan Sleilaty

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