title: High-sensitivity cardiac troponin I in the general population--defining reference populations for the determination of the 99th percentile in the Gutenberg Health Study.
abstract: BACKGROUND
  The 99th percentile of cardiac troponin levels, determined in a reference population, is accepted as threshold for diagnosis of acute myocardial infarction (AMI). However, there is no common consensus of how to define the reference population. The aim of the present study was to determine 99th percentile reference values, determined by a high-sensitivity assay (hsTnI), according to different health status and cardiovascular risk factor prevalence in a large population-based sample.
  
  
  METHODS
  Troponin I was determined using the Abbott ARCHITECT STAT highly sensitive troponin I immunoassay in 4138 participants of the Gutenberg Health Study.
  
  
  RESULTS
  hsTnI was detectable in 81.6% of all individuals. The 99th percentile of the overall population was 27 ng/L. Age and gender had a prominent influence on these values. Exclusion of individuals with elevated natriuretic peptide levels or cardiac abnormalities resulted in lower 99th percentile values, whereas exclusion of individuals with an impaired estimated glomerular filtration rate (eGFR) or with prevalent coronary artery disease/myocardial infarction (CAD/MI) did not result in a meaningful change.
  
  
  CONCLUSIONS
  Troponin I, measured by a high-sensitivity assay, can be reliably detected in the vast majority of the general population. hsTnI values were dependent on age, gender as well as structural and functional cardiac abnormalities.
authors.forename: Tanja
authors.initials: T
authors.lastname: Zeller
authors.forename: Francisco
authors.initials: F
authors.lastname: Ojeda
authors.forename: Fabian J
authors.initials: FJ
authors.lastname: Brunner
authors.forename: Philipp
authors.initials: P
authors.lastname: Peitsmeyer
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel
authors.forename: Harald
authors.initials: H
authors.lastname: Binder
authors.forename: Norbert
authors.initials: N
authors.lastname: Pfeiffer
authors.forename: Matthias
authors.initials: M
authors.lastname: Michal
authors.forename: Philipp S
authors.initials: PS
authors.lastname: Wild
authors.forename: Stefan
authors.initials: S
authors.lastname: Blankenberg
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Lackner
mesh_terms: D001774:Blood Chemical Analysis / Q000592:standards*; D005060:Europe; D005260:Female; D006304:Health Status; D006801:Humans; D057230:Limit of Detection; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D011634:Public Health; D012016:Reference Values; D019210:Troponin I / Q000097:blood*
chemical_list: D019210:Troponin I