title: Aged-related increase of high sensitive Troponin T and its implication in acute myocardial infarction diagnosis of elderly patients.
abstract: High sensitive cardiac Troponin T (hs-cTnT) represents an important tool in acute myocardial infarction (AMI) diagnosis. Even though the hs-cTnT evaluation is relevant for AMI diagnosis in elderly patients characterized by clinical and instrumental atypical presentation, the overall reliability in elderly patients is unknown. We aimed at: (1) defining the hs-cTnT 99th percentile value in an aged healthy reference population and (2) testing hs-cTnT diagnostic accuracy in elderly patients with a suspected AMI. 294 healthy subjects (50-105 years old) and 299 elderly patients (75-96 years old) with suspected AMI at presentation, were enrolled. Conventional cTnT, hs-cTnT, NT-proBNP and creatinine levels were determined in all participants. Our main results are: (1) a significant hs-cTnT age-related increase was observed in an healthy reference population ranging 50-105 years old; (2) hs-cTnT levels showed an age-related multimodal distribution in the healthy reference population: 16 ng/L corresponds to the 99th percentile in subjects ranging 50-75 years old, whereas 70.6 ng/L corresponds to the 99th percentile in subjects ≥75 years old; (3) 86.8 ng/L resulted the hs-cTnT cut-off value with the highest efficiency in AMI diagnosis of geriatric patients. Our data suggest that the hs-cTnT cut-off value must be age-tailored to improve the AMI diagnostic accuracy.
authors.affiliation: Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy. f.olivieri@univpm.it
authors.forename: Fabiola
authors.initials: F
authors.lastname: Olivieri
authors.forename: Roberta
authors.initials: R
authors.lastname: Galeazzi
authors.forename: Davide
authors.initials: D
authors.lastname: Giavarina
authors.forename: Roberto
authors.initials: R
authors.lastname: Testa
authors.forename: Angela Marie
authors.initials: AM
authors.lastname: Abbatecola
authors.forename: Artan
authors.initials: A
authors.lastname: Çeka
authors.forename: Paola
authors.initials: P
authors.lastname: Tamburrini
authors.forename: Franco
authors.initials: F
authors.lastname: Busco
authors.forename: Raffaella
authors.initials: R
authors.lastname: Lazzarini
authors.forename: Daniela
authors.initials: D
authors.lastname: Monti
authors.forename: Claudio
authors.initials: C
authors.lastname: Franceschi
authors.forename: Antonio Domenico
authors.initials: AD
authors.lastname: Procopio
authors.forename: Roberto
authors.initials: R
authors.lastname: Antonicelli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood*; D003404:Creatinine / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D020107:Troponin T / Q000097:blood*
chemical_list: D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D003404:Creatinine