Age-specific reference values for the 5th generation cardiac troponin T assay in Chinese children

Area of Science:

• Pediatric Cardiology
• Clinical Biochemistry
• Biomarker Research

Background:

• Cardiac troponin T (cTnT) assays, traditionally used for adults, are increasingly vital in pediatric cardiology.
• Establishing normative values is essential for accurate interpretation of cTnT levels in children.

Purpose of the Study:

• To determine the age-specific 99th percentile upper reference limits (URLs) for cTnT in apparently healthy Chinese children.
• To provide crucial data for the clinical application of cTnT assays in pediatric populations.

Main Methods:

• Serum cTnT levels were measured in 1280 healthy Chinese children using the Roche Elecsys Troponin T Gen 5 STAT assay.
• Age-specific 99th percentile URLs and 90% confidence intervals were calculated following CLSI C28-A3 guidelines.
• Analysis included comparisons between age subgroups and sexes.

Main Results:

• The 99th percentile URLs for cTnT were established as 38 ng/L (1 to <4 months), 26 ng/L (4 to ≤12 months), and 12 ng/L (1 to 18 years).
• Boys exhibited slightly higher cTnT levels than girls (P = .003) in the 1-18 year age group.
• The assay had limitations in detecting low cTnT concentrations in 50% of girls aged 1-18 years.

Conclusions:

• This study provides the first age-specific normative values for cTnT in Chinese children using a contemporary assay.
• These reference ranges are critical for the accurate interpretation of cTnT results in pediatric cardiology, aiding diagnosis and prognosis.
• The findings highlight potential sex-based differences and assay limitations that warrant consideration in clinical practice.