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Defining a reference population to determine the 99th percentile of a contemporary sensitive cardiac troponin I assay

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Defining a reference population to determine the 99th percentile of a contemporary sensitive cardiac troponin I assay. / Keller, Till; Ojeda, Francisco; Zeller, Tanja; Wild, Philipp S; Tzikas, Stergios; Sinning, Christoph R; Peetz, Dirk; Münzel, Thomas; Blankenberg, Stefan; Lackner, Karl J.

In: INT J CARDIOL, Vol. 167, No. 4, 20.08.2013, p. 1423-1439.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Keller, T, Ojeda, F, Zeller, T, Wild, PS, Tzikas, S, Sinning, CR, Peetz, D, Münzel, T, Blankenberg, S & Lackner, KJ 2013, 'Defining a reference population to determine the 99th percentile of a contemporary sensitive cardiac troponin I assay', INT J CARDIOL, vol. 167, no. 4, pp. 1423-1439. https://doi.org/10.1016/j.ijcard.2012.04.063

APA

Keller, T., Ojeda, F., Zeller, T., Wild, P. S., Tzikas, S., Sinning, C. R., Peetz, D., Münzel, T., Blankenberg, S., & Lackner, K. J. (2013). Defining a reference population to determine the 99th percentile of a contemporary sensitive cardiac troponin I assay. INT J CARDIOL, 167(4), 1423-1439. https://doi.org/10.1016/j.ijcard.2012.04.063

Vancouver

Keller T, Ojeda F, Zeller T, Wild PS, Tzikas S, Sinning CR et al. Defining a reference population to determine the 99th percentile of a contemporary sensitive cardiac troponin I assay. INT J CARDIOL. 2013 Aug 20;167(4):1423-1439. https://doi.org/10.1016/j.ijcard.2012.04.063

Bibtex

@article{bf1b7b1f6cb84cce8b97a92f97b3c065,
title = "Defining a reference population to determine the 99th percentile of a contemporary sensitive cardiac troponin I assay",
abstract = "BACKGROUND: Diagnosis of acute myocardial infarction (AMI) according to the universal definition is based on ischemic symptoms, imaging findings and elevated myocardial necrosis markers, preferably cardiac troponin I/T with diagnostic threshold representing the 99th percentile of a reference population. It is not clearly defined if this should be an unselected population-based or a healthy cohort with respect to cardiac diseases. Aim of the current study was to describe the distribution of troponin I using a sensitive assay and to evaluate the impact of cardiac diseases and cardiovascular risk factors in apparently healthy individuals.METHODS: Troponin I was determined using a contemporary sensitive assay (TnI Ultra, Siemens) with 10% coefficient of variation (0.03 ng/mL) below the published 99th percentile (0.04 ng/mL) in 5000 participants (49.2% female) of the Gutenberg Health Study, a community-based, prospective, observational single-center cohort study. The calculated 99 th percentile cut-offs were tested in 1818 patients with suspected AMI.RESULTS: Troponin I concentration representing the 99th percentile of the overall study population was 0.04 ng/mL. Excluding individuals with prevalent cardiovascular disease lowers the 99th percentile to 0.034 ng/mL. Exclusion of individuals with traditional risk factors or elevated natriuretic peptide leads to further reduction with 0.029/0.028 ng/mL. These lower cut-offs detect more patients at risk in individuals with suspected AMI. Correlations of troponin I with age, gender and traditional risk factors were observed.CONCLUSIONS: Troponin I concentrations in apparently healthy individuals are dependent on prevalent cardiovascular diseases, traditional risk factors, gender and age. Application of corresponding cut-offs in diagnosis of AMI alters the group of patients potentially at risk.",
keywords = "Adult, Age Factors, Aged, Biomarkers/blood, Cardiovascular Diseases/blood, Cohort Studies, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Population Surveillance/methods, Prospective Studies, Reference Values, Risk Factors, Sex Factors, Troponin I/blood",
author = "Till Keller and Francisco Ojeda and Tanja Zeller and Wild, {Philipp S} and Stergios Tzikas and Sinning, {Christoph R} and Dirk Peetz and Thomas M{\"u}nzel and Stefan Blankenberg and Lackner, {Karl J}",
note = "Copyright {\textcopyright} 2012 Elsevier Ireland Ltd. All rights reserved.",
year = "2013",
month = aug,
day = "20",
doi = "10.1016/j.ijcard.2012.04.063",
language = "English",
volume = "167",
pages = "1423--1439",
journal = "INT J CARDIOL",
issn = "0167-5273",
publisher = "Elsevier Ireland Ltd",
number = "4",

}

RIS

TY - JOUR

T1 - Defining a reference population to determine the 99th percentile of a contemporary sensitive cardiac troponin I assay

AU - Keller, Till

AU - Ojeda, Francisco

AU - Zeller, Tanja

AU - Wild, Philipp S

AU - Tzikas, Stergios

AU - Sinning, Christoph R

AU - Peetz, Dirk

AU - Münzel, Thomas

AU - Blankenberg, Stefan

AU - Lackner, Karl J

N1 - Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

PY - 2013/8/20

Y1 - 2013/8/20

N2 - BACKGROUND: Diagnosis of acute myocardial infarction (AMI) according to the universal definition is based on ischemic symptoms, imaging findings and elevated myocardial necrosis markers, preferably cardiac troponin I/T with diagnostic threshold representing the 99th percentile of a reference population. It is not clearly defined if this should be an unselected population-based or a healthy cohort with respect to cardiac diseases. Aim of the current study was to describe the distribution of troponin I using a sensitive assay and to evaluate the impact of cardiac diseases and cardiovascular risk factors in apparently healthy individuals.METHODS: Troponin I was determined using a contemporary sensitive assay (TnI Ultra, Siemens) with 10% coefficient of variation (0.03 ng/mL) below the published 99th percentile (0.04 ng/mL) in 5000 participants (49.2% female) of the Gutenberg Health Study, a community-based, prospective, observational single-center cohort study. The calculated 99 th percentile cut-offs were tested in 1818 patients with suspected AMI.RESULTS: Troponin I concentration representing the 99th percentile of the overall study population was 0.04 ng/mL. Excluding individuals with prevalent cardiovascular disease lowers the 99th percentile to 0.034 ng/mL. Exclusion of individuals with traditional risk factors or elevated natriuretic peptide leads to further reduction with 0.029/0.028 ng/mL. These lower cut-offs detect more patients at risk in individuals with suspected AMI. Correlations of troponin I with age, gender and traditional risk factors were observed.CONCLUSIONS: Troponin I concentrations in apparently healthy individuals are dependent on prevalent cardiovascular diseases, traditional risk factors, gender and age. Application of corresponding cut-offs in diagnosis of AMI alters the group of patients potentially at risk.

AB - BACKGROUND: Diagnosis of acute myocardial infarction (AMI) according to the universal definition is based on ischemic symptoms, imaging findings and elevated myocardial necrosis markers, preferably cardiac troponin I/T with diagnostic threshold representing the 99th percentile of a reference population. It is not clearly defined if this should be an unselected population-based or a healthy cohort with respect to cardiac diseases. Aim of the current study was to describe the distribution of troponin I using a sensitive assay and to evaluate the impact of cardiac diseases and cardiovascular risk factors in apparently healthy individuals.METHODS: Troponin I was determined using a contemporary sensitive assay (TnI Ultra, Siemens) with 10% coefficient of variation (0.03 ng/mL) below the published 99th percentile (0.04 ng/mL) in 5000 participants (49.2% female) of the Gutenberg Health Study, a community-based, prospective, observational single-center cohort study. The calculated 99 th percentile cut-offs were tested in 1818 patients with suspected AMI.RESULTS: Troponin I concentration representing the 99th percentile of the overall study population was 0.04 ng/mL. Excluding individuals with prevalent cardiovascular disease lowers the 99th percentile to 0.034 ng/mL. Exclusion of individuals with traditional risk factors or elevated natriuretic peptide leads to further reduction with 0.029/0.028 ng/mL. These lower cut-offs detect more patients at risk in individuals with suspected AMI. Correlations of troponin I with age, gender and traditional risk factors were observed.CONCLUSIONS: Troponin I concentrations in apparently healthy individuals are dependent on prevalent cardiovascular diseases, traditional risk factors, gender and age. Application of corresponding cut-offs in diagnosis of AMI alters the group of patients potentially at risk.

KW - Adult

KW - Age Factors

KW - Aged

KW - Biomarkers/blood

KW - Cardiovascular Diseases/blood

KW - Cohort Studies

KW - Cross-Sectional Studies

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Population Surveillance/methods

KW - Prospective Studies

KW - Reference Values

KW - Risk Factors

KW - Sex Factors

KW - Troponin I/blood

U2 - 10.1016/j.ijcard.2012.04.063

DO - 10.1016/j.ijcard.2012.04.063

M3 - SCORING: Journal article

C2 - 22560907

VL - 167

SP - 1423

EP - 1439

JO - INT J CARDIOL

JF - INT J CARDIOL

SN - 0167-5273

IS - 4

ER -