Age-specific reference values for the 5th generation cardiac troponin T assay in Chinese children

Abstract

The clinical use of the cardiac troponin T (cTnT) assay was limited to the adult population in the diagnosis and prognosis of myocardial injury. However, emerging studies indicated its significant value in the assessment of pediatric cardiology, and it has been routinely measured in most hospitals. Our study investigated the normative values of cTnT in Chinese children and reported the age-specific 99th percentile cut-off for them.A total of 1280 apparently healthy Chinese children were enrolled in our study. Serum levels of cTnT were analyzed on the Roche Elecsys Troponin T Gen 5 STAT assay. According to the Clinical and Laboratory Standards Institute C28-A3 guideline, the 99th percentile upper reference limits (URLs) with 90% confidence intervals (CIs) were calculated in different age subgroups.The 99th percentile URL was 38 (90%CI: 37.0-51.0) ng/L for 1 to <4 months old, 26 (90%CI: 25.2-28.5) ng/L for 4 to 12 months old, and 12 (90%CI: 11.1-12.9) ng/L for 1 to 18 years old, respectively. For subjects aged from 1 to 18 years, boys had slightly higher cTnT levels than girls (P = .003), while our assay could not measure low cTnT concentrations (≥the limit of detection) in 50% girls.Our study provided age-specific URLs of cTnT for Chinese children, with the 5th generation cTnT assay from Roche Diagnostics. It had significant clinical implications in the interpretation and use of test results for pediatric cardiology.

Myocardial Injury Thresholds for 4 High-Sensitivity Troponin Assays in a Population-Based Sample of US Children and Adolescents

“…13 The few research studies that have reported pediatric hs-cTn 99th percentile URLs have suggested important differences from adult URLs but were undertaken in relatively small convenience samples of children and adolescents who were attending clinical care appointments. [14][15][16][17] Therefore, the generalizability of previously reported URLs for hs-cTn assays to healthy children and adolescents in the general US population is unknown.…”