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Influence of Population Selection on the 99th Percentile Reference Value for Cardiac Troponin Assays.
MedLine Citation:
PMID:  22100808     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
OBJECTIVE:We sought to determine the effect of patient selection on the 99th reference percentile of 2 sensitive and 1 high-sensitivity (hs) cardiac troponin assays in a well-defined reference population.METHODS:Individuals >45 years old were randomly selected from 7 representative local community practices. Detailed information regarding the participants was collected via questionnaires. The healthy reference population was defined as individuals who had no history of vascular disease, hypertension, or heavy alcohol intake; were not receiving cardiac medication; and had blood pressure <140/90 mmHg, fasting blood glucose <110 mg/dL (approximately 6 mmol/L), estimated creatinine clearance >60 mL · min(-1) · (1.73 m(2))(-1), and normal cardiac function according to results of echocardiography. Samples were stored at -70 °C until analysis for cardiac troponin I (cTnI) and cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide.RESULTS:Application of progressively more stringent population selection strategies to the initial baseline population of 545 participants until the only individuals who remained were completely healthy according to the study criteria reduced the number of outliers seen and led to a progressive decrease in the 99th-percentile value obtained for the Roche hs-cTnT assay and the sensitive Beckman cTnI assay but not for the sensitive Siemens Ultra cTnI assay. Furthermore, a sex difference found in the baseline population for the hs-cTnT (P = 0.0018) and Beckman cTnI assays (P < 0.0001) progressively decreased with more stringent population selection criteria.CONCLUSIONS:The reference population selection strategy significantly influenced the 99th percentile reference values determined for troponin assays and the observed sex differences in troponin concentrations.
Authors:
Paul O Collinson; Yen Ming Heung; David Gaze; Frances Boa; Roxy Senior; Robert Christenson; Fred S Apple
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-11-18
Journal Detail:
Title:  Clinical chemistry     Volume:  -     ISSN:  1530-8561     ISO Abbreviation:  -     Publication Date:  2011 Nov 
Date Detail:
Created Date:  2011-11-21     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421549     Medline TA:  Clin Chem     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Departments of Cardiology and.
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