Myocardial Injury Thresholds for 4 High-Sensitivity Troponin Assays in a Population-Based Sample of US Children and Adolescents
Authors' conclusion
Because myocardial infarction is rare in children and adolescents, the use of statistically more precise and reliable sex-specific 97.5th percentile high-sensitivity troponin URLs might be considered to define pediatric myocardial injury.
Study context
- Population
- Children and adolescents aged 1 to 18 years, 1999–2004 National Health and Nutrition Examination Survey; strictly defined healthy subgroup4,029 healthy subgroup
- Participants
- 5,695 children
- Exposure
- 4 high-sensitivity troponin assays: hs-TnT and hs-TnI
- Outcome
- 99th and 97.5th percentile URLs for each assay
Methodological detailspopulation-based, nonparametric percentile estimation
- Population-based
- Nonparametric percentile estimation
Main finding
As reported in the abstract
99th percentile URL
Observational data: associations, not effects.
Further findings
- Roche hs-TnT: males vs females (ng/L)
- 11 (95% CI, 10-12) vs 6 (95% CI, 6-7)
- Abbott hs-TnI: males vs females (ng/L)
- 9 (95% CI, 7-10) vs 5 (95% CI, 4-6)
- Siemens hs-TnI: males vs females (ng/L)
- 21 (95% CI, 18-25) vs 11 (95% CI, 9-13)
- Ortho hs-TnI: males vs females (ng/L)
- 4 (95% CI, 3-5) vs 2 (95% CI, 1-3)
- 97.5th percentile upper reference limits (URLs) more precise (tighter 95% CIs) and more stable across analytic approaches than 99th
Original publication
Myocardial Injury Thresholds for 4 High-Sensitivity Troponin Assays in a Population-Based Sample of US Children and Adolescents. Circulation. Published 20 April 2023. doi:10.
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