Key result
Long-term within-subject biological variation estimates for hs-cTnI and hs-cTnT in healthy individuals were 15.1% and 11.3%, respectively, compared to short-term estimates of 4.3% and 5.3%.
Why the study?
Studies assessing biological variation of cardiac-specific troponins have reported widely varying within-subject biological variation estimates across different sampling intervals and states of health.
Meta-Analysis
This meta-analysis provides robust biological variation estimates for hs-cTnI and hs-cTnT, enabling the use of reference change values to aid in the diagnosis and prognosis of myocardial injury.
Long-term CVI should guide hs-cTn RCV use in serial testing; meta-analysis delivers robust estimates for healthy and diseased populations.
BACKGROUND: Many studies have assessed the biological variation (BV) of cardiac-specific troponins (cTn), reporting widely varying within-subject BV (CVI) estimates. The aim of this study was to provide meta-analysis-derived BV estimates for troponin I (cTnI) and troponin T (cTnT) for different sampling intervals and states of health. METHODS: Relevant studies were identified by a systematic literature search. Studies were classified according to their methodological quality by the Biological Variation Data Critical Appraisal Checklist (BIVAC). Meta-analyses of BIVAC-compliant studies were performed after stratification by cTn isoform, exclusion of results below the limit of detection, states of health, and sampling interval to deliver reference change values (RCV), index of individuality (II) and analytical performance specifications (APS) for these settings. RESULTS: Sixteen and 15 studies were identified for cTnI and cTnT, respectively, out of which 6 received a BIVAC grade A. Five studies had applied contemporary cTnI assays, but none contemporary cTnT. High-sensitivity (hs-) cTnI and cTnT delivered similar estimates in all settings. Long-term CVI estimates (15.1; 11.3%) derived from healthy individuals were higher than short-term (4.3%; 5.3%) for hs-cTnI and hs-cTnT, respectively, although confidence intervals overlapped. Estimates derived from diseased subjects were similar to estimates in healthy individuals for all settings. CONCLUSIONS: This study provides robust estimates for hs-cTnI and hs-cTnT applicable for different clinical settings and states of health, allowing for the use of RCV both to aid in the diagnosis of myocardial injury and for prognosis. BV-based APS appear too strict for some currently available technologies.
No takes yet. Share an insight, caveat, or question.
Díaz–Garzón et al. (2020) conducted a meta-analysis in Healthy and diseased individuals. High-sensitivity cardiac troponin I and T (hs-cTnI and hs-cTnT) sampling was evaluated on Within-subject biological variation (CVI) estimates. Long-term within-subject biological variation estimates for hs-cTnI and hs-cTnT in healthy individuals were 15.1% and 11.3%, respectively, compared to short-term estimates of 4.3% and 5.3%.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: