Transient troponin elevations in the blood of healthy young children
Julia M Potter1, Gus Koerbin, Walter P Abhayaratna
1Australian National University Medical School, Canberra, ACT 0200, Australia.
Insights
Cardiac troponin T (TnT) was detected in the blood of healthy children, with prevalence varying significantly between schools and years. This suggests transient, non-cardiac causes, possibly infective agents, may be responsible for detectable troponin levels.
Area of Science:
- Pediatric Cardiology
- Biomarker Research
- Infectious Disease Epidemiology
Background:
- Cardiac troponin is a marker of myocardial injury.
- High-sensitivity troponin assays can detect lower concentrations.
- Troponin may be present in healthy individuals.
Purpose of the Study:
- To investigate the presence and prevalence of troponin T (TnT) in healthy children.
- To explore variations in TnT levels within a pediatric cohort.
Main Methods:
- Community-based prospective study of healthy children aged 8, 10, and 12 years.
- Measurement of high-sensitivity troponin T (hs-TnT) in blood samples.
- Analysis of 727 children with at least one blood sample collected.
Main Results:
- Troponin was detected in 28.6% of healthy children across at least one sample.
- Positive troponin detection rates ranged from 14.0% to 20.3% at different collection times.
- Significant variation in troponin prevalence was observed between schools and across different years.
Conclusions:
- Low concentrations of troponin can be transiently present in healthy children without cardiac injury.
- The observed between-school and yearly variations suggest a potential transient infective agent.
- Findings challenge the interpretation of troponin solely as a marker of cardiac necrosis in pediatric populations.
Aims:
Whilst cardiac troponin is considered to be indicative of cardiac necrosis, the advent of new high sensitivity assays for troponin suggests that troponin may be present in the blood of healthy persons. We have examined a cohort of healthy children and measured TnT in their blood.
Methods And Results:
In this community-based prospective study, we collected blood samples from a large cohort of healthy children at ages 8, 10 and 12 years and measured hs-TnT on these samples. 727 children had at least one blood sample collected and of these 28.6% had at least one sample in which troponin was detected. The number of samples with a positive troponin at each period of blood collection varied between 14.0% and 20.3%. Statistical analysis showed that the prevalence of positive TnT varied between schools and the between school pattern was different in different years.
Conclusions:
Low concentrations of troponin may be seen transiently in healthy children with no evidence of cardiac injury. This between-school by year variation is highly significant and is suggestive of a transient infective agent.
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