Key result
Pediatric troponins and natriuretic peptides lack standardized cut-offs, restricting clinical utility due to widespread heterogeneity.
Why the study?
There are no validated guidelines or standardized cut-off values for interpreting cardiac biomarkers such as cardiac troponins and natriuretic peptides in pediatric laboratory medicine.
There is a critical need to establish evidence-based, standardized cut-offs for cardiac biomarkers in the pediatric population to overcome current analytical and clinical limitations.
Heterogeneity restricts pediatric biomarker utility; leaves open standardized cut-off validation across assays and populations.
Currently, there are no validated guidelines or recommendations for how to interpret cardiac biomarkers in the pediatric population. The most commonly used cardiac biomarkers are cardiac troponins and natriuretic peptides, but the clinical value of common cardiac biomarkers in pediatric laboratory medicine is restricted due to age- and sex-specific interpretations, and there are no standardized cut-off values. The results from the studies on reference values, as well as results from clinical studies, are difficult to compare with identical studies due to the heterogeneity of subject characteristics (gestational and chronological age, sex, pubertal status, menstrual cycle, exercise), assay characteristics (type of assay, generation of assay, analytical platform used), and experimental protocol characteristics (prospective or retrospective studies, reference population selection, patient population selection, inclusion and exclusion criteria, number of subjects). Future studies need to establish evidence-based cut-offs for specific indications to optimize utilization and standardize the interpretation of common cardiac biomarkers in neonates, children, and adolescents. The aim of this article was to summarize the current analytical and clinical limitations of cardiac troponins and natriuretic peptides in the pediatric population, as informed by the existing published literature.
No takes yet. Share an insight, caveat, or question.
Topić et al. (2025) conducted a review in Pediatric cardiac biomarker interpretation. Cardiac troponins and natriuretic peptides was evaluated. Cardiac troponins and natriuretic peptides in pediatric populations lack standardized cut-offs, with clinical utility restricted by heterogeneity in subject, assay, and protocol characteristics.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: