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

Dorien M. Kimenai, Ronald M. A. Henry, Carla J. H. van der Kallen, Pieter C. Dagnelie, Miranda T. Schram, Coen D. A. Stehouwer, Jeroen D. E. van Suijlen, Marijke Niens, Otto Bekers, Simone J. S. Sep, Nicolaas C. Schaper, Marja P. van Dieijen-Visser, Steven J. R. Meex*

*Corresponding author for this work

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Abstract

Objective 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 26ng/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. Methods A healthy reference population was derived from a population-based cohort (the Maastricht Study: n=3451; age: 40-75years). Individuals with diabetes mellitus, a history of cardiovascular disease, cardiac ischaemia on ECG, N-terminal pro-brain natriuretic peptide >125ng/L or estimated glomerular filtration rate
Original languageEnglish
Pages (from-to)610-616
JournalHeart
Volume102
Issue number8
DOIs
Publication statusPublished - Apr 2016

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