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

Gus KOERBIN, Walter P. Abhayaratna, Julia M. Potter, Fred S. Apple, Allan S. Jaffe, Tricia H. Ravalico, Peter E. Hickman

Research output: Contribution to journalArticle

68 Citations (Scopus)

Abstract

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 10.3 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.
Original languageEnglish
Pages (from-to)636-1643
Number of pages1008
JournalClinical Biochemistry
Volume46
Issue number16-17
DOIs
Publication statusPublished - 2013

Fingerprint

Troponin T
Troponin I
Assays
Population
Troponin
Healthy Volunteers
Age Groups
History
Health

Cite this

KOERBIN, G., Abhayaratna, W. P., Potter, J. M., Apple, F. S., Jaffe, A. S., Ravalico, T. H., & Hickman, P. E. (2013). Effect of population selection on 99th percentile values for a high sensitivity cardiac troponin I and T assays. Clinical Biochemistry, 46(16-17), 636-1643. https://doi.org/10.1016/j.clinbiochem.2013.08.004
KOERBIN, Gus ; Abhayaratna, Walter P. ; Potter, Julia M. ; Apple, Fred S. ; Jaffe, Allan S. ; Ravalico, Tricia H. ; Hickman, Peter E. / Effect of population selection on 99th percentile values for a high sensitivity cardiac troponin I and T assays. In: Clinical Biochemistry. 2013 ; Vol. 46, No. 16-17. pp. 636-1643.
@article{02c70a338f514eb095dcb67b1353c425,
title = "Effect of population selection on 99th percentile values for a high sensitivity cardiac troponin I and T assays",
abstract = "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 10.3 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.",
keywords = "99th percentile, Reference population, Troponin I, Troponin T",
author = "Gus KOERBIN and Abhayaratna, {Walter P.} and Potter, {Julia M.} and Apple, {Fred S.} and Jaffe, {Allan S.} and Ravalico, {Tricia H.} and Hickman, {Peter E.}",
year = "2013",
doi = "10.1016/j.clinbiochem.2013.08.004",
language = "English",
volume = "46",
pages = "636--1643",
journal = "Clinical Biochemistry",
issn = "0009-9120",
publisher = "Elsevier Inc.",
number = "16-17",

}

KOERBIN, G, Abhayaratna, WP, Potter, JM, Apple, FS, Jaffe, AS, Ravalico, TH & Hickman, PE 2013, 'Effect of population selection on 99th percentile values for a high sensitivity cardiac troponin I and T assays', Clinical Biochemistry, vol. 46, no. 16-17, pp. 636-1643. https://doi.org/10.1016/j.clinbiochem.2013.08.004

Effect of population selection on 99th percentile values for a high sensitivity cardiac troponin I and T assays. / KOERBIN, Gus; Abhayaratna, Walter P.; Potter, Julia M.; Apple, Fred S.; Jaffe, Allan S.; Ravalico, Tricia H.; Hickman, Peter E.

In: Clinical Biochemistry, Vol. 46, No. 16-17, 2013, p. 636-1643.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effect of population selection on 99th percentile values for a high sensitivity cardiac troponin I and T assays

AU - KOERBIN, Gus

AU - Abhayaratna, Walter P.

AU - Potter, Julia M.

AU - Apple, Fred S.

AU - Jaffe, Allan S.

AU - Ravalico, Tricia H.

AU - Hickman, Peter E.

PY - 2013

Y1 - 2013

N2 - 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 10.3 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.

AB - 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 10.3 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.

KW - 99th percentile

KW - Reference population

KW - Troponin I

KW - Troponin T

U2 - 10.1016/j.clinbiochem.2013.08.004

DO - 10.1016/j.clinbiochem.2013.08.004

M3 - Article

VL - 46

SP - 636

EP - 1643

JO - Clinical Biochemistry

JF - Clinical Biochemistry

SN - 0009-9120

IS - 16-17

ER -