Hospital Admission and Myocardial Injury Prevalence after the Clinical Introduction of a High-Sensitivity Cardiac Troponin I Assay

[摘要] To the Editor:A cardiac troponin concentration above the 99th percentile is an indication of myocardial injury, and only a subset of all increased concentrations are caused by acute myocardial infarction (AMI).1 Interestingly, Sandoval et al. suggest that fewer AMI diagnoses may occur when using a high-sensitivity cardiac troponin I (hs-cTnI) assay with sex-specific 99th percentile cutoffs (1). This may well be a result of the superior analytical characteristics of the hs-cTnI assay, particularly at low concentrations near the decision levels (2). An important metric that was not reported by Sandoval et al. was the prevalence of myocardial injury using the hs-cTnI assay with sex-specific cutoffs. By extrapolating data from Tables 1 and 2 in their publication (1), we have estimated the prevalence of myocardial injury in the female population to be 46% (61/133) compared with 37% (66/177) in the male population. In another UK population, using the same hs-cTnI assay (Abbott Architect) with sex-specific cutoffs, the proportion of women with myocardial injury was >30% compared with <30% for men in the same population (3). Both of these studies suggest an increased prevalence of myocardial injury in the female population when using sex-specific cutoffs. The application of …

[学科分类] 过敏症与临床免疫学