High-Sensitivitycardiac Troponinsin Cardio-Healthy Subjects: A Cardiovascular Magnetic Resonance Imaging Study

Area of Science:

• Cardiology
• Biomarkers
• Medical Diagnostics

Background:

• High-sensitivity cardiac troponin (hs-cTn) assays are vital for diagnosing cardiovascular diseases.
• Accurate upper reference limits (URL) for hs-cTn are essential, but subclinical disease can affect these values.
• Stringent screening is necessary to establish reliable hs-cTn URLs in healthy populations.

Purpose of the Study:

• To determine the 99th percentile upper reference limits (URL) of two hs-cTn assays in a rigorously screened healthy cohort.
• To investigate the influence of sex, age, and renal function on hs-cTn levels.
• To assess the correlation between hs-cTnT and hs-cTnI and their association with cardiac structure and function.

Main Methods:

• Evaluated 779 healthy subjects using cardiovascular magnetic resonance (CMR) and estimated glomerular filtration rate (eGFR).
• Measured 99th percentile URL for hs-cTnT (Roche) and hs-cTnI (Abbott).
• Analyzed correlations between hs-cTn assays and associations with CMR-derived cardiac parameters and eGFR.

Main Results:

• The 99th percentile URLs for hs-cTnT (15.2 ng/L) and hs-cTnI (21.2 ng/L) were similar to published values.
• Males exhibited higher hs-cTn levels than females for both assays.
• Lower eGFR was linked to higher hs-cTnT, while both troponin types correlated with myocardial mass and cardiac volumes; hs-cTnI also associated with strain measures and LV trabeculations.

Conclusions:

• Stringent screening using CMR confirms established hs-cTn URLs.
• Significant differences exist between hs-cTnT and hs-cTnI assays, particularly in detectable levels in younger individuals and associations with cardiac parameters.
• Assay selection for hs-cTn should consider cardiac conditions, patient demographics, and local factors.