Abstract
Objective:This study aims to establish the 99th percentile upper reference limits of high sensitive cardiac troponin I in a healthy Pakistani population.Methods:It was an Observational cohort study carried out in Department of Chemical Pathology and Endocrinology Rehman Medical Institute Peshawar, over the period of one year (January 2019- December 2019). Total 299 cardio-healthy males and females were interviewed and taken past medical history. Based on history, clinical examination, echocardiogram and laboratory data including results of estimated glomerular filtration rate (eGFR) and N-terminal pro-B-type natriureteric peptide (NT-proBNP), subjects with possible subclinical diseases were excluded. High Sensitive Cardiac Troponin I (hs-cTtrop I) was analysed on Abbot ARCHITECT STAT ci8200 using chemiluminescent immunoassay technique. The 99th percentile upper reference limit (URL) of hs-cTtrop I was determined using a non-parametric statistic, while gender specific results were compared.Results:In this study, 178 males (59.5%) and 121 females (40.5%) were included. The median Interquartile ranges (IQR) of age was 57 (11.6) for males and 56 (13) for females. The 99th percentile URL hs-cTtrop I was found to be 33.9 ng/L, while gender specific values were 38.41ng/L and 15.73ng/L for males and females, respectively (p= 0.0045).Conclusion:High sensitivity cardiac troponin I 99th percentile URL in our study population was found to be 33.9 ng/L with gender specific values being 38.41 ng/L and 15.73ng/L for males and females respectively. Troponin I in males was substantially high in comparison with females.
Highlights
Chest pain is among the most common causes for hospitalization
Rule-in / rule-out of myocardial infarction (MI) is critical for patient care and resource allocation in patients presenting at the emergency department
Quantitative data like age and Troponin I were presented as median and interquartile ranges (IQR)
Summary
Chest pain is among the most common causes for hospitalization. The biomarkers of choice for the diagnosis of Acute myocardial injury are cardiac troponin I (cTnI) and cardiac troponin T (cTnT), since they are the most sensitive and cardiac-specific laboratory tests of myocardial injury globally available. Pak J Med Sci September - October 2020 Vol 36 No 6 www.pjms.org.pk 1303 used in clinical setting.[1] Introducing high sensitive cTn assays has contributed to improved awareness of myocardial damage other than acute coronary syndromes.[2] Myocardial injury is by far the most frequent cause of irregular troponin findings, and its incidence is expected to rise with an aging population, increased cardiac comorbidity, and increased troponin assay sensitivity.[3]
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