Effect of population selection on 99th percentile values for a high sensitivity cardiac troponin I and T assays

被引:94
作者
Koerbin, Gus [1 ,2 ]
Abhayaratna, Walter P. [3 ,4 ]
Potter, Julia M. [1 ,4 ]
Apple, Fred S. [5 ,6 ]
Jaffe, Allan S. [7 ,8 ]
Ravalico, Tricia H. [9 ]
Hickman, Peter E. [1 ,4 ]
机构
[1] ACT Pathol, Garran, ACT 2605, Australia
[2] Univ Canberra, Canberra, ACT 2601, Australia
[3] Canberra Hosp, Dept Cardiol, Garran, ACT 2605, Australia
[4] Australian Natl Univ, Sch Med, Canberra, ACT 0200, Australia
[5] Hennepin Cty Med Ctr, Dept Lab Med & Pathol, Minneapolis, MN 55415 USA
[6] Univ Minnesota, Sch Med, Minneapolis, MN 55455 USA
[7] Mayo Clin & Mayo Grad Sch Med, Dept Internal Med, Div Cardiovasc, Rochester, MN USA
[8] Mayo Clin & Mayo Grad Sch Med, Dept Lab Med, Core Clin Lab Serv, Rochester, MN USA
[9] Abbott Diagnost, Abbott Pk, IL 60064 USA
关键词
Troponin I; Troponin T; 99th percentile; Reference population; EUROPEAN-SOCIETY; PROGNOSTIC VALUE; HEART-FAILURE; RISK; ASSOCIATION; PERFORMANCE; DYSFUNCTION; VALIDATION; MORTALITY; WOMEN;
D O I
10.1016/j.clinbiochem.2013.08.004
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
Objective: Using objective laboratory and clinical criteria to more accurately determine the 99th percentile values for cardiac troponin I and T. Design and methods: We measured cardiac troponin T and cardiac troponin I with high-sensitivity assays in a large cohort of apparently healthy community subjects and calculated 99th percentiles for different sexes and ages. Subjects with possible subclinical disease were eliminated based on objective laboratory criteria, eGFR and NT-proBNP, and clinical criteria, history and examination and echocardiogram. Results: For men and women of all ages, separately, more than 50% of subjects were excluded using these criteria, with a lesser proportion of younger subjects being excluded. In men aged <75 years, the 99th percentile for cTnI decreased by more than 50% from 22.9 ng/L to 103 ng/L. In other age groups and for cTnT the decrease was smaller (%) but still considerable. Conclusions: For establishing cardiac troponin 99th percentiles, simply using self-reporting of health is insufficient. Objective laboratory measures and clinical and echocardiographic assessments are essential to define a healthy population, especially in older persons. (C) 2013 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.
引用
收藏
页码:1636 / 1643
页数:8
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