Distribution and specificity of high-sensitivity cardiac troponin T in older adults without acute cardiac conditions: cross-sectional results from the population-based AugUR study
| Autor: | Dietl, Alexander, Zimmermann, Martina E., Brandl, Caroline, Wallner, Stefan, Burkhardt, Ralph, Maier, Lars S., Luchner, Andreas, Heid, Iris M., Stark, Klaus J. |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
ddc:610 geriatric medicine 610 Medizin Myocardial Infarction Cardiovascular Medicine clinical chemistry Sensitivity and Specificity Healthy Volunteers Cross-Sectional Studies Troponin T Reference Values cardiology Germany Medicine Humans Female Non-ST Elevated Myocardial Infarction Biomarkers cardiac epidemiology Aged |
| Zdroj: | BMJ Open BMJ Open, Vol 11, Iss 11 (2021) |
| ISSN: | 2044-6055 |
| Popis: | Objective European guidelines recommended a uniform upper reference limit of high-sensitivity cardiac troponin T (hsTnT) to rule out non-ST segment elevation myocardial infarction. Our study aimed to provide a hsTnT reference distribution and to assess the specificity of the 14 ng/L cut-off value in the mobile population ���70 years of age. Design A cross-sectional analysis was performed in the German AugUR study (Altersbezogene Untersuchungen zur Gesundheit der University of Regensburg). Setting Study population was the mobile population aged 70+ years living in the city and county of Regensburg, Germany. Participants A random sample was derived from the local population registries of residence. Of the 5644 individuals invited, 1133 participated (response ratio=20.1%). All participants came to the study centre and were mentally and physically mobile to conduct the protocol (face-to-face interview, blood draw and standardised transthoracic echocardiography). None of the participants was in an acute state of myocardial infarction. Results Among the 1129 individuals with hsTnT measurements (overall median=10.0 ng/L (25th, 75th percentile)=(7.0, 15.0 ng/L)), hsTnT was higher among the older individuals and higher among men (men 70���74 years median=9.6 ng/L (7.2, 13.1 ng/L); men 90���95 years median=21.2 ng/L (14.6, 26.0 ng/L); women 70���74 years median=6.3 ng/L (4.7, 8.7 ng/L); and women 90���95 years median=18.0 ng/L (11.0, 21.0 ng/L)). In participants with impaired kidney function (eGFRcrea 79 years (specificity=34%). In a healthy subgroup (n=96, none of the following: overt heart disease, impaired renal function, blood pressure >160/100 mm Hg, left ventricular hypertrophy and diastolic/systolic dysfunction), specificity was 90%. Conclusion In the elderly population without acute myocardial infarction, hsTnT further increases with age showing different levels for men and women. The specificity of the 14 ng/L cut-off is considerably lower than 99%, even in healthy subjects. |
| Databáze: | OpenAIRE |
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