The Correlation of Serum Troponin Levels with Age and Gender in Healthy Individuals

Abstract

Background and Objectives: Cardiac Troponin (cTn) values play a pivotal role in the diagnosis of ischemic heart disease (IHD). The advent of high sensitivity assays of both cTnI and cTnT have revolutionized the way IHD is diagnosed and managed. These high sensitivity assays have also highlighted some hitherto unknown features of cTns. It is being suggested that healthy individuals have different values depending on their gender and age. This study was planned to study these differences in a healthy population.
Methods: A total of 700 apparently healthy individuals, 350 males and 350 females were included in the study. Their ages were also noted. Their cTnI values were recorded and analyzed to find the effect of age and gender on their cTnI levels. cTn I hs was detected on immunoassay analyser Siemens Atellica® Solution IM 1300 Analyzer, USA. The cut off for normal was taken at 45.2 pg/ml as per the company's manual.
Results: Males had mean=9.39+8.6 cTnI values and females had mean=6.57+5.66.There was a statistically significant difference in cTnI levels between males and females (p-value < 0.0001) with male subjects showing higher levels. Increasing age had a positive correlation with cTnI levels in both genders but it was not statistically significant (correlation coefficient, r, 0.178 for males and 0.246 for females).
Conclusion: The reference ranges for cTn values should be separately defined for males and females. Increasing age may have an influence on the diagnostic performance of cTns.These factors should be taken into consideration so that decision for each patient is individualized instead of assuming that the binary threshold criteria is set in stone.
Keywords: Cardiac troponin, ischemic heart disease, reference range, age, gender