The 99th percentile cut-off values for high-sensitivity cardiac troponin I in healthy subjects vary significantly by age and gender, suggesting the need for age- and sex-specific reference limits.
BACKGROUND: The aim of this study was to evaluate the distribution of cardiac troponin I (cTnI) values, measured by the ADVIA TnI-Ultra method (Siemens Medical Solutions Diagnostics SrL) in healthy subjects and to characterize its relation to gender, age, as well as to N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP). METHODS: A Caucasian population of 692 healthy subjects (311 males and 381 females) with a mean (SD) age of 45.3 (17.3) years range 11-89 years; females 46.5 (17.3) years, males 43.8 (17.1) years was enrolled. The presence of cardiac or systemic acute or chronic diseases was excluded by history and accurate clinical evaluation. RESULTS: A significant difference was found between the cTnI values in men and women (men: median 0.012 microg/L, range from undetectable values to 0.196 microg/L; women: median 0.008 microg/L, range from undetectable values to 0.130 microg/L; p<0.0001 by Mann-Whitney U-test). When a multiple regression analysis was performed, NT-proBNP, gender and age significantly contributed to the regression with cTnI (R=0.444, p<0.0001). CONCLUSIONS: Our data indicate that cut-off values, based on the 99th percentile of cTnI distribution in apparently healthy subjects, can significantly vary according to age and gender of the reference population.
Clerico et al. (Tue,) studied this question.
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