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

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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