Cross-sectional study
Myocardial Injury Thresholds for 4 High-Sensitivity Troponin Assays in U.S. Adults
- Cross-sectional study
- nationally representative sample (National Health and Nutrition Examination Survey (NHANES) 1999-2004)
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 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)
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 |
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:10.1016/j.jacc.2023.03.403
Summarised from the published abstract; every number is checked against it