Evangelos Giannitsis1, Matthias Mueller-Hennessen2, Tanja Zeller3, Anna Schuebler2, Matthias Aurich2, Moritz Biener4, Mehrshad Vafaie2, Kiril M Stoyanov2, Marco Ochs2, Johannes Riffel2, Derliz Mereles4, Stefan Blankenberg3, Hugo A Katus4. 1. Heidelberg University Hospital, Department of Internal Medicine III, Im Neuenheimer Feld 410, 69115 Heidelberg, Germany. Electronic address: evangelos_giannitsis@med.uni-heidelberg.de. 2. Heidelberg University Hospital, Department of Internal Medicine III, Im Neuenheimer Feld 410, 69115 Heidelberg, Germany. 3. University Heart Centre Hamburg, Clinic for General and Interventional Cardiology, Martinistrasse 52, 20246 Hamburg, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany. 4. Heidelberg University Hospital, Department of Internal Medicine III, Im Neuenheimer Feld 410, 69115 Heidelberg, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Heidelberg/Mannheim, Heidelberg, Germany.
Abstract
OBJECTIVE: To determine gender-specific reference limits of high-sensitivity (hs) cardiac troponins (cTn) and validity of hs assay designation for both genders. METHODS: After screening with a questionnaire, 827 presumably healthy individuals were further selected based on clinical criteria (n = 740), clinical criteria plus cardiac imaging including stress magnetic resonance imaging or stress echocardiography (n = 726), and extended cardio-pulmonary parameters (n = 626). Blood samples were measured with hs-cTnT (Roche Diagnostics) on a cobas e602 analyzer as well as hs-cTnI (Abbott Diagnostics) on an ARCHITECTi2000SR. The impact of health definition, statistical methods, instrument selection and limit of detection (LoD) on overall and gender-specific 99th percentiles was assessed. RESULTS: Median age was 56 years (50.9% female) for the total study cohort. 99th percentiles for females and males ranged between 13.1 and 13.3 ng/L and 16.8-19.9 ng/L for hs-cTnT as well as 10.3-12.5 ng/L and 27.4-29.7 ng/L for hs-cTnI depending on health definition. Utilization of stricter health definition criteria reduced the difference of the gender-specific 99th percentiles between males and females for hs-cTnT to 3.7 ng/L (males 16.8 ng/L, females 13.1 ng/L), whereas the difference rather increased for hs-cTnI to 19.4 ng/L (males 29.7 ng/L, females 10.3 ng/L). Values > LoD could be measured in the majority of males and females using hs-TnT (81.4-83.3% and 96.5-96.9%, respectively). In contrast, values > LoD could not be observed in the majority of females using hs-cTnI (38.4-41.1%). CONCLUSIONS: In a well-phenotyped healthy cohort, reference values for hs-cTnT were slightly higher, whereas hs-cTnI cut-offs were considerably lower than previously observed. Gender differences were more pronounced in hs-cTnI than in hs-cTnT and were further reduced for hs-cTnT by application of stricter health definition criteria. Contrary to hs-cTnI, hs-cTnT fulfilled criteria for hs designation for both genders.
OBJECTIVE: To determine gender-specific reference limits of high-sensitivity (hs) cardiac troponins (cTn) and validity of hs assay designation for both genders. METHODS: After screening with a questionnaire, 827 presumably healthy individuals were further selected based on clinical criteria (n = 740), clinical criteria plus cardiac imaging including stress magnetic resonance imaging or stress echocardiography (n = 726), and extended cardio-pulmonary parameters (n = 626). Blood samples were measured with hs-cTnT (Roche Diagnostics) on a cobas e602 analyzer as well as hs-cTnI (Abbott Diagnostics) on an ARCHITECTi2000SR. The impact of health definition, statistical methods, instrument selection and limit of detection (LoD) on overall and gender-specific 99th percentiles was assessed. RESULTS: Median age was 56 years (50.9% female) for the total study cohort. 99th percentiles for females and males ranged between 13.1 and 13.3 ng/L and 16.8-19.9 ng/L for hs-cTnT as well as 10.3-12.5 ng/L and 27.4-29.7 ng/L for hs-cTnI depending on health definition. Utilization of stricter health definition criteria reduced the difference of the gender-specific 99th percentiles between males and females for hs-cTnT to 3.7 ng/L (males 16.8 ng/L, females 13.1 ng/L), whereas the difference rather increased for hs-cTnI to 19.4 ng/L (males 29.7 ng/L, females 10.3 ng/L). Values > LoD could be measured in the majority of males and females using hs-TnT (81.4-83.3% and 96.5-96.9%, respectively). In contrast, values > LoD could not be observed in the majority of females using hs-cTnI (38.4-41.1%). CONCLUSIONS: In a well-phenotyped healthy cohort, reference values for hs-cTnT were slightly higher, whereas hs-cTnI cut-offs were considerably lower than previously observed. Gender differences were more pronounced in hs-cTnI than in hs-cTnT and were further reduced for hs-cTnT by application of stricter health definition criteria. Contrary to hs-cTnI, hs-cTnT fulfilled criteria for hs designation for both genders.
Authors: Luis García de Guadiana-Romualdo; Daniel Morell-García; Olaia Rodríguez-Fraga; Cristian Morales-Indiano; Ana María Lourdes Padilla Jiménez; José Ignacio Gutiérrez Revilla; Eloísa Urrechaga; José María Álamo; Ana María Hernando Holgado; María Del Carmen Lorenzo-Lozano; Silvia Sánchez Fdez-Pacheco; Patricia de la Hera Cagigal; María Ángeles Juncos Tobarra; Juan A Vílchez; Isabel Vírseda Chamorro; Irene Gutiérrez Garcia; Yolanda Pastor Murcia; Laura Sahuquillo Frías; Laura Altimira Queral; Elisa Nuez-Zaragoza; Juan Adell Ruiz de León; Alicia Ruiz Ripa; Paloma Salas Gómez-Pablos; Iria Cebreiros López; Amaia Fernández Uriarte; Álex Larruzea; María Luisa López Yepes; Natalia Sancho-Rodríguez; María Consuelo Zamorano Andrés; José Pedregosa Díaz; Cristina Acevedo Alcaraz; Alfonso-L Blázquez Manzanera; Sonia Pérez Sanmartín; María Del Carmen Baamonde Calzada; Marina Vera; Elena Valera Nuñez; Magdalena Canalda Campás; Sara García Muñoz; Josep Miquel Bauça; Luis Vicente Gutiérrez; Laura Jiménez Añón; Alfonso Pérez Martínez; Aurelio Pons Castillo; Ruth González Tamayo; Jorge Férriz Vivancos; María José Alcaide Martín; Vicente Ferrer Díaz de Brito Fernández; Vicente Aguadero; María Gloria García Arévalo; María Arnaldos Carrillo; Mercedes González Morales; María Núñez Gárate; Cristina Ruiz Iruela; Patricia Esteban Torrella; Martí Vila Pérez; Jose Manuel Egea-Caparrós; Luis Sáenz; Amparo Galán Ortega; Luciano Consuegra-Sánchez Journal: Eur J Clin Invest Date: 2021-03-15 Impact factor: 5.722
Authors: Danielle M Gualandro; Christian Puelacher; Giovanna Lurati Buse; Noemi Glarner; Francisco A Cardozo; Ronja Vogt; Reka Hidvegi; Celia Strunz; Daniel Bolliger; Johanna Gueckel; Pai C Yu; Marcel Liffert; Ketina Arslani; Alexandra Prepoudis; Daniela Calderaro; Angelika Hammerer-Lercher; Andreas Lampart; Luzius A Steiner; Stefan Schären; Christoph Kindler; Lorenz Guerke; Stefan Osswald; P J Devereaux; Bruno Caramelli; Christian Mueller Journal: Clin Res Cardiol Date: 2021-03-25 Impact factor: 5.460