Establishment of gender related 99th percentile values for cardiac troponin-T among young and middle-aged adult Egyptians

Document Type : Review Article

Authors

1 Department of Chemical Pathology, Medical Research Institute, Alexandria University, Alexandria, Egypt.

2 Department of Cardiology – Military academy of Medicine – Egypt

3 Master’s degree in chemical Pathology – Medical Research Institute – Alexandria University – Egypt

4 Department of Chemical Pathology, Medical Research Institute, Alexandria University Egypt

Abstract

Cardiac troponins are the preferred biomarkers for the diagnosis of acute myocardial infarction (AMI). The stable nature of cardiac troponin T (cTnT) in the circulation and the worldwide available single standardized assay make it a more precise biomarker of AMI. The manufacturer’s proposed upper reference limit (URL) for the high sensitive (hs)-cTnT assay does not take into consideration patients’ gender, age or race.

The study aimed at establishing and comparing gender-specific upper reference limit for cardiac troponin-T among apparently healthy young adult Egyptians.

240 adult Egyptians (120 males and 120 females) participated in this study. Serum cTnT was determined using a commercially available hs-cTnT electrochemiluminescent immunoassay. The gender related 99th percentile values were then calculated to represent the URLs for cTnT according to the CLSI and IFCC approved guidelines.

Serum hs-cTnT was significantly higher in males compared to females (p < 0.001). The p99 URL for hs-cTnT in females (12.6 ng/L) was lower than that of males (19.6 ng/L). Applying an age cutoff value of 36 years to all, serum hs-cTnT level was significantly lower among those aged Conclusion:

An adult patient in early diagnosis of AMI by increasing both assay’s specificity among adult The use of age and gender specific 99th percentile value as an URL of hs-cTnT assay would benefit males (decreasing over-diagnosis) and assay’s sensitivity among adult females (decreasing under-diagnosis).

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