Higher troponin T serum concentrations in hospital patients without diagnosed cardiac diseases compared to a population-based cohort
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Higher troponin T serum concentrations in hospital patients without diagnosed cardiac diseases compared to a population-based cohort. / Gessner, Romy; Gärtner, Christiane; Schmidt, Maria; Eckelt, Felix; Wirkner, Kerstin; Löffler, Markus; Uhe, Tobias; Isermann, Berend; Laufs, Ulrich; Kaiser, Thorsten; Wachter, Rolf.
in: CLIN CHEM LAB MED, Jahrgang 61, Nr. 11, 26.10.2023, S. 2046-2052.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Higher troponin T serum concentrations in hospital patients without diagnosed cardiac diseases compared to a population-based cohort
AU - Gessner, Romy
AU - Gärtner, Christiane
AU - Schmidt, Maria
AU - Eckelt, Felix
AU - Wirkner, Kerstin
AU - Löffler, Markus
AU - Uhe, Tobias
AU - Isermann, Berend
AU - Laufs, Ulrich
AU - Kaiser, Thorsten
AU - Wachter, Rolf
N1 - © 2023 Walter de Gruyter GmbH, Berlin/Boston.
PY - 2023/10/26
Y1 - 2023/10/26
N2 - OBJECTIVES: Upper reference limits of high-sensitivity cardiac troponin T (hs-cTnT) are derived from healthy, population-based cohorts, and are frequently exceeded in hospitalized patients. In this study we aim to systematically examine the differences between in-hospital patients with no diagnosed cardiac diseases and a population-based cohort.METHODS: Retrospective analyses were performed in two independent cohorts. We included 5,652 participants of the prospective population-based LIFE cohort as well as 9,300 patients having been treated at our hospital between 2014 and 2021. In both cohorts, subjects with diagnosed or suspected cardiac diseases were excluded. We used Spearman's rank correlation for correlation analyses of hs-cTnT serum concentrations and age. Sex- and age-adjusted 99th percentiles for hs-cTnT in subjects with preserved renal function were obtained in both cohorts.RESULTS: In both cohorts, hs-cTnT serum concentrations positively correlated with age. Male sex was associated with higher hs-cTnT serum concentrations. Persons treated in hospital showed significantly higher hs-cTnT concentrations in females and males aged above 50. While in the population-based cohort only 99th percentile hs-cTnT results of females aged above 70 and males aged above 60 years exceeded the assay's upper reference limit, the 99th percentiles of in-hospital females over 40 years and males of all age groups exceeded this threshold.CONCLUSIONS: Besides age and sex, hospitalization per se is correlated with higher serum concentrations of hs-cTnT in most age groups. Our results indicate, that unconditionally applying current hs-cTnT cut-offs to inpatients might overestimate myocardial infarction and potentially lead to overdiagnosis.
AB - OBJECTIVES: Upper reference limits of high-sensitivity cardiac troponin T (hs-cTnT) are derived from healthy, population-based cohorts, and are frequently exceeded in hospitalized patients. In this study we aim to systematically examine the differences between in-hospital patients with no diagnosed cardiac diseases and a population-based cohort.METHODS: Retrospective analyses were performed in two independent cohorts. We included 5,652 participants of the prospective population-based LIFE cohort as well as 9,300 patients having been treated at our hospital between 2014 and 2021. In both cohorts, subjects with diagnosed or suspected cardiac diseases were excluded. We used Spearman's rank correlation for correlation analyses of hs-cTnT serum concentrations and age. Sex- and age-adjusted 99th percentiles for hs-cTnT in subjects with preserved renal function were obtained in both cohorts.RESULTS: In both cohorts, hs-cTnT serum concentrations positively correlated with age. Male sex was associated with higher hs-cTnT serum concentrations. Persons treated in hospital showed significantly higher hs-cTnT concentrations in females and males aged above 50. While in the population-based cohort only 99th percentile hs-cTnT results of females aged above 70 and males aged above 60 years exceeded the assay's upper reference limit, the 99th percentiles of in-hospital females over 40 years and males of all age groups exceeded this threshold.CONCLUSIONS: Besides age and sex, hospitalization per se is correlated with higher serum concentrations of hs-cTnT in most age groups. Our results indicate, that unconditionally applying current hs-cTnT cut-offs to inpatients might overestimate myocardial infarction and potentially lead to overdiagnosis.
KW - Female
KW - Humans
KW - Male
KW - Troponin T
KW - Retrospective Studies
KW - Prospective Studies
KW - Inpatients
KW - Myocardial Infarction/diagnosis
KW - Biomarkers
U2 - 10.1515/cclm-2023-0040
DO - 10.1515/cclm-2023-0040
M3 - SCORING: Journal article
C2 - 37272166
VL - 61
SP - 2046
EP - 2052
JO - CLIN CHEM LAB MED
JF - CLIN CHEM LAB MED
SN - 1434-6621
IS - 11
ER -
