| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Proteomics and Protein Markers |
1 Department of Laboratory Medicine and Pathology, Hennepin County Medical Center and the University of Minnesota School of Medicine, Minneapolis, MN 55415.
aAddress correspondence to this author at: Hennepin County Medical Center, Clinical Laboratories MC 812, 701 Park Ave., Minneapolis, MN 55415. Fax 612-904-4229; e-mail fred.apple{at}co.hennepin.mn.us.
Background: The European Society of Cardiology/American College of Cardiology (ESC/ACC) consensus document for definition of myocardial infarction (MI) is predicated on increased cardiac troponin or creatine kinase (CK) MB mass above the 99th percentile reference limit. The purpose of this study was to determine the plasma (heparin) 99th percentile reference limits for the leading in vitro diagnostic cardiac troponin and CKMB mass assays.
Methods: Blood (heparin plasma) was obtained from healthy adults (n = 696; age range, 18–84 years) stratified by gender and ethnicity. Cardiac troponin I (cTnI) and T (cTnT) and CKMB mass concentrations were measured by eight assays. Reference limits were determined by nonparametric statistical analysis.
Results: Two cTnI assays demonstrated at least a 1.2- to 2.5-fold higher 99th percentile for males vs females, with the mean concentrations significantly higher for males (P <0.05). Two cTnI assays also demonstrated a 1.1- to 2.8-fold higher 99th percentile for blacks vs Caucasians, with the mean concentrations significantly higher for blacks (P = 0.05). There was a 13-fold variance between the lowest measured 99th percentile (0.06 µg/L) and the highest (0.8 µg/L). All CKMB assays demonstrated a 1.2- to 2.6-fold higher 99th percentile for males vs females, with mean concentrations significantly higher for males (P <0.0001). Four CKMB assays also showed significantly higher (1.2- to 2.7-fold) mean concentrations for blacks (P <0.02) vs Caucasians.
Conclusions: The heparin-plasma 99th percentile reference limits for cardiac troponin and CKMB mass provide an evidence base in support of the ESC, ACC, and American Heart Association guidelines for detection of myocardial injury. Selective gender and ethnic differences were demonstrated. These data allow clinicians, trialists, and epidemiologists a common point for operational use.
The following articles in journals at HighWire Press have cited this article:
|
|
 |
|
  F. S. Apple A New Season for Cardiac Troponin Assays: It's Time to Keep a Scorecard Clin. Chem., July 1, 2009; 55(7): 1303 - 1306. [Full Text] [PDF]
|
|
|
|
 |
|
 A. H. B. Wu Gender-Specific Decision Limits for Cardiac Troponin for Risk Stratification? Anesth. Analg., March 1, 2009; 108(3): 686 - 688. [Full Text] [PDF]
|
|
|
|
|
|
K. M. Eggers, A. S. Jaffe, L. Lind, P. Venge, and B. Lindahl Value of Cardiac Troponin I Cutoff Concentrations below the 99th Percentile for Clinical Decision-Making Clin. Chem., January 1, 2009; 55(1): 85 - 92. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Venge, S. James, L. Jansson, and B. Lindahl Clinical Performance of Two Highly Sensitive Cardiac Troponin I Assays Clin. Chem., January 1, 2009; 55(1): 109 - 116. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. K. Saenger and A. S. Jaffe Requiem for a Heavyweight: The Demise of Creatine Kinase-MB Circulation, November 18, 2008; 118(21): 2200 - 2206. [Full Text] [PDF]
|
|
|
|
 |
|
 H. D White Evolution of the definition of myocardial infarction: what are the implications of a new universal definition? Heart, June 1, 2008; 94(6): 679 - 684. [Full Text] [PDF]
|
|
|
|
 |
|
 J. R Tate, W. Ferguson, R. Bais, K. Kostner, T. Marwick, and A. Carter The determination of the 99th centile level for troponin assays in an Australian reference population Ann Clin Biochem, May 1, 2008; 45(3): 275 - 288. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. v. d. Kerkhof, B. Peters, and V. Scharnhorst Performance of the Advia Centaur second-generation troponin assay TnI-Ultra compared with the first-generation cTnI assay Ann Clin Biochem, May 1, 2008; 45(3): 316 - 317. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Kavsak, A. M. Newman, D. T. Ko, G. E. Palomaki, V. Lustig, A. R. MacRae, and A. S. Jaffe Is a Pattern of Increasing Biomarker Concentrations Important for Long-Term Risk Stratification in Acute Coronary Syndrome Patients Presenting Early after the Onset of Symptoms? Clin. Chem., April 1, 2008; 54(4): 747 - 751. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. O. McFalls, H. B. Ward, T. E. Moritz, F. S. Apple, S. Goldman, G. Pierpont, G. C. Larsen, B. Hattler, K. Shunk, F. Littooy, et al. Predictors and outcomes of a perioperative myocardial infarction following elective vascular surgery in patients with documented coronary artery disease: results of the CARP trial Eur. Heart J., February 1, 2008; 29(3): 394 - 401. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Kavsak, D. T. Ko, A. M. Newman, G. E. Palomaki, V. Lustig, A. R. MacRae, and A. S. Jaffe Risk Stratification for Heart Failure and Death in an Acute Coronary Syndrome Population Using Inflammatory Cytokines and N-Terminal Pro-Brain Natriuretic Peptide Clin. Chem., December 1, 2007; 53(12): 2112 - 2118. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. E.F. Melanson, M. J. Tanasijevic, and P. Jarolim Cardiac Troponin Assays: A View From the Clinical Chemistry Laboratory Circulation, October 30, 2007; 116(18): e501 - e504. [Full Text] [PDF]
|
|
|
|
|
|
NACB Writing Group Members, F. S. Apple, R. L. Jesse, L. K. Newby, A. H.B. Wu, and R. H. Christenson National Academy of Clinical Biochemistry and IFCC Committee for Standardization of Markers of Cardiac Damage Laboratory Medicine Practice Guidelines: Analytical Issues for Biochemical Markers of Acute Coronary Syndromes Circulation, April 3, 2007; 115(13): e352 - e355. [Full Text] [PDF]
|
|
|
|
|
|
NACB WRITING GROUP MEMBERS, F. S. Apple, R. L. Jesse, L. K. Newby, A. H.B. Wu, R. H. Christenson, NACB COMMITTEE MEMBERS, R. H. Christenson, F. S. Apple, C. P. Cannon, et al. National Academy of Clinical Biochemistry and IFCC Committee for Standardization of Markers of Cardiac Damage Laboratory Medicine Practice Guidelines: Analytical Issues for Biochemical Markers of Acute Coronary Syndromes Clin. Chem., April 1, 2007; 53(4): 547 - 551. [Full Text] [PDF]
|
|
|
|
|
|
P. A. Kavsak, A. M. Newman, V. Lustig, A. R. MacRae, G. E. Palomaki, D. T. Ko, J. V. Tu, and A. S. Jaffe Long-Term Health Outcomes Associated with Detectable Troponin I Concentrations Clin. Chem., February 1, 2007; 53(2): 220 - 227. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. G. Neilan, J. L. Januzzi, E. Lee-Lewandrowski, T.-T. Ton-Nu, D. M. Yoerger, D. S. Jassal, K. B. Lewandrowski, A. J. Siegel, J. E. Marshall, P. S. Douglas, et al. Myocardial Injury and Ventricular Dysfunction Related to Training Levels Among Nonelite Participants in the Boston Marathon Circulation, November 28, 2006; 114(22): 2325 - 2333. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. M. Brewster, G. Mairuhu, N. R. Bindraban, R. P. Koopmans, J. F. Clark, and G. A. van Montfrans Creatine Kinase Activity Is Associated With Blood Pressure Circulation, November 7, 2006; 114(19): 2034 - 2039. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Kavsak, A. R. MacRae, G. E. Palomaki, A. M. Newman, D. T. Ko, V. Lustig, J. V. Tu, and A. S. Jaffe Health Outcomes Categorized by Current and Previous Definitions of Acute Myocardial Infarction in an Unselected Cohort of Troponin-Naive Emergency Department Patients Clin. Chem., November 1, 2006; 52(11): 2028 - 2035. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
V. L. Roger, J. M. Killian, S. A. Weston, A. S. Jaffe, J. Kors, P. J. Santrach, H. Tunstall-Pedoe, and S. J. Jacobsen Redefinition of Myocardial Infarction: Prospective Evaluation in the Community Circulation, August 22, 2006; 114(8): 790 - 797. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. W. Wallace, S. M. Abdullah, M. H. Drazner, S. R. Das, A. Khera, D. K. McGuire, F. Wians, M. S. Sabatine, D. A. Morrow, and J. A. de Lemos Prevalence and Determinants of Troponin T Elevation in the General Population Circulation, April 25, 2006; 113(16): 1958 - 1965. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. J. Howell, J. P. Thompson, A. F. Nimmo, C. Snowden, N. D. Edwards, J. Carlisle, M.-S. Suleiman, and A. Baumbach Relationship between perioperative troponin elevation and other indicators of myocardial injury in vascular surgery patients Br. J. Anaesth., March 1, 2006; 96(3): 303 - 309. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. A. Khan, B. R. Hemmelgarn, M. Tonelli, C. R. Thompson, and A. Levin Prognostic Value of Troponin T and I Among Asymptomatic Patients With End-Stage Renal Disease: A Meta-Analysis Circulation, November 15, 2005; 112(20): 3088 - 3096. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Rajappa and A. Sharma Biomarkers of Cardiac Injury: An Update Angiology, November 1, 2005; 56(6): 677 - 691. [Abstract] [PDF]
|
|
|
|
|
|
S. Eriksson, T. Ilva, C. Becker, J. Lund, P. Porela, K. Pulkki, L.-M. Voipio-Pulkki, and K. Pettersson Comparison of Cardiac Troponin I Immunoassays Variably Affected by Circulating Autoantibodies Clin. Chem., May 1, 2005; 51(5): 848 - 855. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Cook, D. Taylor, M. France, G. Burrows, E. Manning, G. Lyratzopoulos, P. McElduff, P. Lewis, M. Martin, and R.F. Heller Survival among hospital in-patients with troponin T elevation below levels defining myocardial infarction QJM, April 1, 2005; 98(4): 275 - 282. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
F. S. Apple and M. M. Murakami Cardiac Troponin and Creatine Kinase MB Monitoring during In-Hospital Myocardial Reinfarction Clin. Chem., February 1, 2005; 51(2): 460 - 463. [Full Text] [PDF]
|
|
|
|
|
|
F. Pagani, F. Stefini, G. Micca, M. Toppino, F. Manoni, L. Romano, P. Hoffer, A. Iervasi, M. Caputo, R. Dorizzi, et al. Multicenter Evaluation of the TOSOH AIA-Pack Second-Generation Cardiac Troponin I Assay Clin. Chem., September 1, 2004; 50(9): 1707 - 1709. [Full Text] [PDF]
|
|
|
|
|
|
F. S. Apple and M. M. Murakami Serum 99th Percentile Reference Cutoffs for Seven Cardiac Troponin Assays Clin. Chem., August 1, 2004; 50(8): 1477 - 1479. [Full Text] [PDF]
|
|
|
|
|
|
M. Panteghini Role and importance of biochemical markers in clinical cardiology Eur. Heart J., July 2, 2004; 25(14): 1187 - 1196. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K A A Fox, J Birkhead, R Wilcox, C Knight, and J Barth British Cardiac Society Working Group on the definition of myocardial infarction Heart, June 1, 2004; 90(6): 603 - 609. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Walters Beckman Coulter Access Creatine Kinase MB Assay Clin. Chem., February 1, 2004; 50(2): 458 - 458. [Full Text] [PDF]
|
|
|
|
|
|
J. C. Lin, F. S. Apple, M. M. Murakami, and R. V. Luepker Rates of Positive Cardiac Troponin I and Creatine Kinase MB Mass among Patients Hospitalized for Suspected Acute Coronary Syndromes Clin. Chem., February 1, 2004; 50(2): 333 - 338. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Giannitsis and H. A. Katus 99th Percentile and Analytical Imprecision of Troponin and Creatine Kinase-MB Mass Assays: An Objective Platform for Comparison of Assay Performance Clin. Chem., August 1, 2003; 49(8): 1248 - 1249. [Full Text] [PDF]
|
|
Read all eLetters
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
