High-sensitivity cardiac troponin I in the general population - defining reference populations for the determination of the 99th percentile in the Gutenberg Health Study
High-sensitivity cardiac troponin I in the general population - defining reference populations for the determination of the 99th percentile in the Gutenberg Health Study
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DOI：
10.1515/cclm-2014-0619
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发表时间：
2015-04-01
影响因子：
6.8
通讯作者：
Lackner, Karl J.
中科院分区：
文献类型：
--
作者：
Zeller, Tanja;Ojeda, Francisco;Lackner, Karl J.
背景资料：在参考人群中测定的心肌肌钙蛋白水平的第99百分位数被接受为急性心肌梗死（AMI）的诊断阈值。然而，对于如何定义参考人群，没有达成共识。本研究的目的是根据不同的健康状况和心血管危险因素的患病率，在大样本人群中确定第99百分位参考值，由高灵敏度测定（hsTnI）确定。方法：使用Abbott ARCHITECT STAT高灵敏度肌钙蛋白I免疫测定法测定古滕贝格健康研究的4138名参与者的肌钙蛋白I。结果：hsTnI阳性率为81.6%。总体人群的第99百分位数为27纳克/升。年龄和性别对这些价值观有显著影响。排除利钠肽水平升高或心脏异常的个体导致较低的第99百分位数值，而排除估计肾小球滤过率（eGFR）受损或患有冠状动脉疾病/心肌梗死（CAD/MI）的个体并没有导致有意义的变化。肌钙蛋白I，通过高灵敏度测定，可以可靠地检测到在绝大多数的一般人群。hsTnI值依赖于年龄、性别以及心脏结构和功能异常。
Background: The 99th percentile of cardiac troponin levels, determined in a reference population, is accepted as threshold for diagnosis of acute myocardial infarction (AMI). However, there is no common consensus of how to define the reference population. The aim of the present study was to determine 99th percentile reference values, determined by a high-sensitivity assay (hsTnI), according to different health status and cardiovascular risk factor prevalence in a large population-based sample.Methods: Troponin I was determined using the Abbott ARCHITECT STAT highly sensitive troponin I immunoassay in 4138 participants of the Gutenberg Health Study.Results: hsTnI was detectable in 81.6% of all individuals. The 99th percentile of the overall population was 27 ng/L. Age and gender had a prominent influence on these values. Exclusion of individuals with elevated natriuretic peptide levels or cardiac abnormalities resulted in lower 99th percentile values, whereas exclusion of individuals with an impaired estimated glomerular filtration rate (eGFR) or with prevalent coronary artery disease/myocardial infarction (CAD/MI) did not result in a meaningful change.Conclusions: Troponin I, measured by a high-sensitivity assay, can be reliably detected in the vast majority of the general population. hsTnI values were dependent on age, gender as well as structural and functional cardiac abnormalities.