Key result
A novel long cardiac troponin T assay demonstrated a 99th percentile upper reference limit of 7.3 ng/l (95% CI 5.6-8.4) in healthy volunteers, remaining low regardless of age and comorbidities.
Why the study?
Measuring intact or minimally fragmented cTnT forms discriminates MI from other conditions better than total cTnT, but long cTnT concentrations in a healthy population required investigation.
What are the reference concentrations of long cTnT in a healthy population, and how do they compare to total cTnT across age and comorbidities?
Observational (n=314)
What are the reference concentrations of long cTnT in a healthy population, and how do they compare to total cTnT across age and comorbidities?
A novel long cTnT assay establishes a 99th percentile URL of 7.3 ng/l in healthy individuals and is not confounded by age or common comorbidities, unlike total cTnT.
Answers are grounded in this paper and cite their sources.
Establishes age- and comorbidity-independent reference limits for long cTnT; leaves open prospective outcome validation before clinical adoption.
BACKGROUND: Cardiac troponin T (cTnT) is an established biomarker in the diagnosis of myocardial infarction (MI). Recent studies show better discrimination between MI and other conditions when measuring only intact or minimally fragmented cTnT forms (long cTnT), compared to current cTnT assays that measure both intact and highly fragmented cTnT forms (total cTnT). This study investigated the long cTnT concentrations in a healthy population. METHODS: Lithium-heparin plasma samples were collected from 314 healthy volunteers aged 21-85 years (59 % female). The samples were analyzed for total cTnT with Roche Elecsys high sensitivity cTnT assay and with a novel upconversion luminescence-based long cTnT assay. RESULTS: The median (25th-75th percentile) long cTnT concentration of the reference population was 2.0 (1.3-3.0) ng/l. The 99th percentile URL for the long cTnT assay was 7.3 (95 % confidence interval, 5.6-8.4) ng/l. Of the healthy population 98 % had long cTnT levels above the detection limit of the assay (0.4 ng/l). The imprecision (coefficient of variation) of the long cTnT assay at the 99th percentile URL was 5.1 %. While total cTnT was heavily associated with age, especially in the older population, long cTnT remained low regardless of age. Common comorbidities and medications were also associated with the total cTnT concentration but not with the long cTnT concentration. CONCLUSIONS: The long cTnT assay fulfills the requirements for a high sensitivity cTnT assay. Healthy individuals have low long cTnT concentrations regardless of age and common comorbidities.
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Tuominen et al. (2025) conducted an observational in Healthy volunteers (n=314). Long cTnT assay vs. Total cTnT assay was evaluated on 99th percentile URL for long cTnT concentration (95% CI 5.6-8.4). A novel long cardiac troponin T assay demonstrated a 99th percentile upper reference limit of 7.3 ng/l (95% CI 5.6-8.4) in healthy volunteers, remaining low regardless of age and comorbidities.
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