Myocardial Injury Thresholds for 4 High-Sensitivity Troponin Assays in U.S. Adults
Authors' conclusion
We found URLs for hs-troponin I assays that were substantially lower than currently listed 99th percentile URLs. There were significant differences in hs-troponin T and I URLs by sex and by age group in healthy U.S. adults but none by race/ethnicity.
Study context
- Population
- US adults in National Health and Nutrition Examination Survey (NHANES) 1999–2004; strictly defined healthy reference subgroup2,746 healthy subgroup
- Participants
- 12,545 adults
- Exposure
- Roche hs-troponin T vs Abbott hs-troponin I vs Ortho hs-troponin I vs Siemens hs-troponin I
- Outcome
- 99th percentile URL of each hs-troponin assay (nonparametric method)
Methodological detailsnationally representative sample (NHANES 1999-2004)
- Nationally representative sample (NHANES 1999-2004)
Main finding
As reported in the abstract
99th percentile URL in healthy reference subgroup
| Group | Value | Manufacturer-reported URL | Manufacturer URL |
|---|---|---|---|
| Hs-troponin T | 99th percentile URL 19 ng/L | 19 ng/L | |
| Abbott hs-troponin I | 99th percentile URL 13 (95% CI 10–15) ng/L | 28 ng/L | |
| Ortho hs-troponin I | 99th percentile URL 5 (95% CI 4–7) ng/L | 11 ng/L | |
| Siemens hs-troponin I | 99th percentile URL 37 (95% CI 27–66) ng/L | 46.5 ng/L |
Value
Hs-troponin T99th percentile URL 19 ng/L
Abbott hs-troponin I99th percentile URL 13 (95% CI 10–15) ng/L
Ortho hs-troponin I99th percentile URL 5 (95% CI 4–7) ng/L
Siemens hs-troponin I99th percentile URL 37 (95% CI 27–66) ng/L
Manufacturer-reported URL
Hs-troponin T19 ng/L
Abbott hs-troponin I— not stated in the abstract
Ortho hs-troponin I— not stated in the abstract
Siemens hs-troponin I— not stated in the abstract
Manufacturer URL
Hs-troponin T— not stated in the abstract
Abbott hs-troponin I28 ng/L
Ortho hs-troponin I11 ng/L
Siemens hs-troponin I46.5 ng/L
Observational data: associations, not effects.
Further findings
URL by sex
- Significant differences in URLs by sex
URL by race/ethnicity
- No significant differences by race/ethnicity
URL by age group
- URLs for all 4 assays significantly lower in healthy adults aged <40 years vs ≥60 years
- all P < 0.001
- Rank sum testing
Original publication
Myocardial Injury Thresholds for 4 High-Sensitivity Troponin Assays in U.S. Adults. J Am Coll Cardiol. Published 23 May 2023. doi:10.
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