Reference Population and Marathon Runner Sera Assessed by Highly Sensitive Cardiac Troponin T and Commercial Cardiac Troponin T and I Assays

Mingels, Alma M.A.; Jacobs, Leo H J; Michielsen, Etienne C.H.J.; Swaanenburg, J. C. J. M.; Wodzig, Will K. W. H.; Dieijen-Visser, Marja van

doi:10.1373/clinchem.2008.106427

Cited by 273 publications

(233 citation statements)

References 37 publications

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“…In 2009, a gender-dependent difference in 99th URL for the highly sensitive cTnT assay (Roche Diagnostics) was also reported by Mingels et al [48] in a reference population of 479 apparently healthy individuals; the observed 99th percentile was 8 ng/L in 215 females, and 18 ng/L in 264 males. Results from larger studies [12,26] confirm the dependence of cTnT values on gender.…”

Section: Gendermentioning

confidence: 54%

“…Moreover, the method used to measure the troponin levels can affect results [25]: due to the low circulating levels of cTnI and cTnT in healthy subjects, only highly sensitive methods allow the accurate evaluation of biomarker variations in the majority of subjects tested, especially when pre-and post-exercise values are both below the 99th URL [8,25]. Importantly, almost 100% of subjects demonstrated a significant increase in circulating levels after exercise, especially when highly sensitive methods were employed [25,[52][53][54][55][56].…”

Section: Physical Exercisementioning

confidence: 99%

“…The kinetic profile of cTnI and cTnT circulating levels after strenuous exercise in apparently healthy subjects [25,40,[52][53][54][55][56][77][78][79][80][81][82][83][84][85][86][87][88][89][90] is different from that usually observed in patients with AMI. It is well known that circulating levels of cTnI and cTnT in patients with uncomplicated type 1 AMI usually peak between 12 and 36 h from beginning of thoracic pain, gradually returning to below the 99th URL value within 5-7 days [1,3,40,76].…”

Section: Mechanisms Of Troponin Release In Cardiac Patients and Healtmentioning

confidence: 99%

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The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications

Clerico

Zaninotto

Ripoli

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

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According to recent international guidelines, including the 2012 Third Universal Definiton of Myocardial Infarction by the Joint ESC/ACCF/AHA/WHF Task Force, an increase in cardiac troponin (cTn) levels over the 99th percentile upper reference limit (99th URL) should be considered clinically relevant, this cut-off being measured with an imprecision ≤10 CV%. In theory 99th URL values strongly depend not only on demographic and physiological variables (i.e. criteria for considering the reference population "healthy"), but also on the analytical performance of cTn methods and mathematical algorithms used for the calculation. The aim of the present article was therefore to review the methodological and pathophysiological factors affecting the evaluation and calculation of the 99th URL for cTn assay. The critical analysis made showed that no uniform procedure is followed, and nor have experts or regulatory bodies provided uniform guidelines for researchers or cTn assays manufacturers as an aid in "their quest to define normality". In particular, little attention has been paid to the way in which a healthy reference population is to be selected, or the criteria for calculating the 99th URL value for cTn assays, thus highlighting the need for international recommendations not only for demographic and physiological variables criteria for defining a healthy reference population, but also for calculating mathematical algorithms for establishing/ calculating clinical decision values. An expert consensus group, comprising laboratory and clinical scientists, biomedical statisticians, industrial and regulatory representatives, should be responsible for drawing up these guidelines.

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Section: Gendermentioning

confidence: 54%

Section: Physical Exercisementioning

confidence: 99%

Section: Mechanisms Of Troponin Release In Cardiac Patients and Healtmentioning

confidence: 99%

See 1 more Smart Citation

The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications

Clerico

Zaninotto

Ripoli

et al. 2017

Clinical Chemistry and Laboratory Medicine (CCLM)

View full text Add to dashboard Cite

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“…The evidence that strenuous exercise can cause alterations in the metabolism and cardiovascular system are derived from several sporting events [2][3][4][5][6] . A meta-analysis of 26 studies demonstrated that troponin elevation occurs in approximately half of the participants of endurance tests, and this increase appears to be more common in shorter duration tests 7 .…”

Section: Introductionmentioning

confidence: 99%

Efeitos agudos do exercício físico prolongado: avaliação após ultramaratona de 24 horas

Passaglia¹,

Emed²,

Barberato³

et al. 2013

Arq. Bras. Cardiol.

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“…In addition, the emergence of hs-cTnT detection kits in clinical trials may facilitate the detection of hs-cTnT in patients with particular diseases, especially with an analytical range of 3-10,000 ng/L and coefficient of variation at 9% using the Elecsys e411 analyzer. The assay was specific for cTnT without interference from human cTnI, cTnC, skeletal muscle TnT, and hemoglobin concentrations up to 1,000 mg/L, above which false lower values could be expected (Mingels et al, 2009). The increase in hs-cTnT concentrations in normal controls is <1%, whereas these concentrations are increased significantly in patients with HF (Alehagen et al, 2010), diabetes mellitus, and ventricular hypertrophy due to unbalanced blood supply and demand.…”

Section: Discussionmentioning

confidence: 95%

High-sensitivity cardiac troponin T is a predictor of recurrent acute coronary syndrome in patients with acute myocardial infarction

Sheng

Kang

et al. 2014

Genet. Mol. Res.

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ABSTRACT. High-sensitivity cardiac troponin T is a useful tool for diagnosing myocardial ischemia. However, its role in the prognosis of patients with acute myocardial infarction has not been studied. Here, the prognostic value of high-sensitivity cardiac troponin T for patients with acute myocardial infarction was investigated. The concentrations of high-sensitivity cardiac troponin T, other clinical chemistry makers, and living habits were investigated at the time of admission in patients with acute coronary syndrome, whereas the high-sensitivity cardiac troponin T concentrations at 6 h after admission and during recovery were analyzed in other patient groups. The concentration of high-sensitivity cardiac troponin T was significantly higher in patients with acute myocardial infarction than in those with other cardiac diseases and in controls (P < 0.01). Based on the standard diagnostic criterion, 134 patients were diagnosed with acute myocardial infarction. Monitoring the change in concentration of high-sensitivity cardiac troponin T in patients with acute coronary syndrome can reduce the risk of recurrence and death.

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Reference Population and Marathon Runner Sera Assessed by Highly Sensitive Cardiac Troponin T and Commercial Cardiac Troponin T and I Assays

Cited by 273 publications

References 37 publications

The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications

The 99th percentile of reference population for cTnI and cTnT assay: methodology, pathophysiology and clinical implications

Efeitos agudos do exercício físico prolongado: avaliação após ultramaratona de 24 horas

High-sensitivity cardiac troponin T is a predictor of recurrent acute coronary syndrome in patients with acute myocardial infarction

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