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Franzini M, Lorenzoni V, Masotti S, Prontera C, Chiappino D, Latta DD, Daves M, Deluggi I, Zuin M, Ferrigno L, Mele A, Marcucci F, Caserta CA, Surace P, Messineo A, Turchetti G, Passino C, Emdin M, Clerico A. The calculation of the cardiac troponin T 99th percentile of the reference population is affected by age, gender, and population selection: a multicenter study in Italy. Clin Chim Acta 2014; 438:376-81. [PMID: 25239669 DOI: 10.1016/j.cca.2014.09.010] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 07/27/2014] [Accepted: 09/08/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND The aim of this study is to determine the 99th upper-reference limit (URL) for cardiac troponin T (cTnT) in Italian apparently healthy subjects. METHODS The reference population was selected from 5 cities: Bolzano (n=290), Milano (CAMELIA-Study, n=287), Montignoso (MEHLP-Study, n=306), Pisa (n=182), and Reggio Calabria (MAREA-Study, n=535). Subjects having cardiac/systemic acute/chronic diseases were excluded. Participants to MEHLP project underwent cardiac imaging investigation. High-sensitive cTnT was measured with Cobas-e411 (Roche Diagnostics). RESULTS We enrolled 1600 healthy subjects [54.6% males; age range 10-90years; mean (SD): 36.4 (21.2) years], including 34.6% aged <20years, 54.5% between 20 and 64years, and 10.9% over 65years. In the youngest the 99th URL was 10.9ng/L in males and 6.8ng/L in females; in adults 23.2ng/L and 10.2ng/L; and in elderly 36.8ng/L and 28.6ng/L. After the exclusion of outliers the 99th URL values were significantly decreased (P<0.05) in particular those of the oldest (13.8ng/L and 14ng/L). MEHLP participants were divided in healthy and asymptomatic, according to known cardiovascular risk factors (HDL, LDL, glucose, C-reactive protein): the 99th URL of cTnT values of these subgroups was significantly different (19.5 vs. 22.7, P<0.05). CONCLUSIONS 99th URL of cTnT values was strongly affected by age, gender, selection of subjects and the statistical evaluation of outliers.
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Affiliation(s)
- Maria Franzini
- Scuola Superiora Sant'Anna, Pisa, Italy; Fondazione Toscana G. Monasterio, Pisa, Italy
| | | | | | | | | | | | - Massimo Daves
- Clinical Biochemical Laboratory, San Maurizio Regional Hospital, Bolzano, ltaly
| | - Irene Deluggi
- Clinical Biochemical Laboratory, San Maurizio Regional Hospital, Bolzano, ltaly
| | - Massimo Zuin
- Department of lnternal Medicine and Liver Unit, School of Medicine San Paolo, University of Milan, Milan, ltaly
| | - Luigina Ferrigno
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanita', Roma, Italy
| | - Alfonso Mele
- Centro Nazionale di Epidemiologia, Sorveglianza e Promozione della Salute, Istituto Superiore di Sanita', Roma, Italy
| | | | | | | | | | | | | | | | - Aldo Clerico
- Scuola Superiora Sant'Anna, Pisa, Italy; Fondazione Toscana G. Monasterio, Pisa, Italy
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