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Sex-Specific Versus...
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Kimenai, Dorien M.
(författare)
Sex-Specific Versus Overall Clinical Decision Limits for Cardiac Troponin I and T for the Diagnosis of Acute Myocardial Infarction : A Systematic Review
- Artikel/kapitelEngelska2018
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American Association for Clinical Chemistry,2018
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printrdacarrier
Nummerbeteckningar
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LIBRIS-ID:oai:DiVA.org:uu-369664
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https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-369664URI
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Språk:engelska
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Sammanfattning på:engelska
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Ämneskategori:ref swepub-contenttype
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Ämneskategori:for swepub-publicationtype
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BACKGROUND: The overall clinical decision limits of high-sensitivity cardiac troponin I (hs-cTnI; 26 ng/L) and T (hs-cTnT; 14 ng/L) may contribute to underdiagnosis of acute myocardial infarction in women. We performed a systematic review to investigate sex-specific and overall 99th percentiles of hs-cTnI and hs-cTnT derived from healthy reference populations. CONTENT: We searched in PubMed and EMBASE for original studies, and by screening reference lists. Reference populations designed to establish 99th percentiles of hs-cTnI (Abbott) and/or hs-cTnT (Roche), published between January 2009 and October 2017, were included. Sex-specific and overall 99th percentile values of hs-cTnI and hs-cTnT were compared with overall clinical decision ranges (hs-cTnI, 23-30 ng/L; hs-cTnT, 13-25 ng/L). Twenty-eight studies were included in the systematic review. Of 16 hs-cTnI and 18 hs-cTnT studies, 14 (87.5%) and 11 (61.1%) studies reported lower femalespecific hs-cTn cutoffs than overall clinical decision ranges, respectively. Conversely, male-specific thresholds of both hs-cTnI and hs-cTnT were in line with currently used overall thresholds, particularly hs-cTnT (90% concordance). The variation of estimated overall 99th percentiles was much higher for hs-cTnI than hs-cTnT (29.4% vs 80.0% of hs-cTnI and hs-cTnT studies reported values within the current overall clinical decision range, respectively). SUMMARY: Our data show substantially lower femalespecific upper reference limits of hs-cTnI and hs-cTnT than overall clinical decision limits of 26 ng/L and 14 ng/L, respectively. The statistical approach strongly affects the hs-cTnI threshold. Downward adjustment of hs-cTn thresholds in women may be warranted to reduce underdiagnosis of acute myocardial infarction in women.
Ämnesord och genrebeteckningar
Biuppslag (personer, institutioner, konferenser, titlar ...)
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Janssen, Emma B.N.J.
(författare)
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Eggers, Kai M.,1962-Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR),Bertil Lindahl(Swepub:uu)kaieg561
(författare)
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Lindahl, Bertil,1957-Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Institutionen för medicinska vetenskaper(Swepub:uu)belin227
(författare)
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den Ruijter, Hester M.
(författare)
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Bekers, Otto
(författare)
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Appelman, Yolande
(författare)
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Meex, Steven J.R.
(författare)
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Uppsala universitetKardiologi
(creator_code:org_t)
Sammanhörande titlar
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Ingår i:Clinical Chemistry: American Association for Clinical Chemistry64:7, s. 1034-10430009-91471530-8561
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Kimenai, Dorien ...
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Janssen, Emma B. ...
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Eggers, Kai M., ...
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Lindahl, Bertil, ...
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den Ruijter, Hes ...
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Bekers, Otto
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Appelman, Yoland ...
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Meex, Steven J.R ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kardiologi
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Clinical Chemist ...
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Uppsala universitet