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Original research
High-sensitivity cardiac troponin I: is ethnicity relevant?
  1. Tejas R Kalaria1,
  2. Nicola Harris1,
  3. Harminder Sensi1,
  4. Ross Valentine1,
  5. Usama Asif1,
  6. Hayley Sharrod-Cole1,
  7. Deon Coley-Grant1,
  8. San San Min1,
  9. Clare Ford2,
  10. Rousseau Gama1,3
  1. 1Clinical Chemistry, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
  2. 2Clinical Biochemistry, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
  3. 3School of Medicine and Clinical Practice, University of Wolverhampton, Wolverhampton, West Midlands, UK
  1. Correspondence to Dr Tejas R Kalaria, Clinical Chemistry, Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, Wolverhampton, UK; tejaskumar.kalaria{at}nhs.net

Abstract

Aims To evaluate 99th percentile upper reference limits (URLs) and investigate ethnic differences for the Abbott Architect high-sensitivity cardiac troponin I (hs-cTnI) in a middle-aged to elderly cosmopolitan population.

Methods In subjects without cardiovascular disease and after outlier exclusion, data on hs-cTnI from 149 white men, 150 white women, 150 South Asian (SA) men and 150 SA women in their sixth, seventh and eight decades were analysed. Each ethnicity–gender–decade subgroup consisted of 50 patients except white men in their sixth decade (n=49).

Results The overall, women and men hs-cTnI 99th percentile URLs were 22.1, 17.9 and 24.8 ng/L, respectively. Median (IQR) hs-cTnI was higher in men (2.7 (1.8–4.1) ng/L) than in women (1.9 (1.1–3.2) ng/L; p<0.001). White men (3.2 (2.2–4.4) ng/L) had higher hs-cTnI than SA men (2.5 (1.6–3.6) ng/L; p<0.001), white women (2.1 (1.3–3.3) ng/L; p<0.001) and SA women (1.6 (1.0–3.0) ng/L; p<0.001). Hs-cTnI in white women was similar to SA women (p=0.07) and SA men (p=0.07). Patients in the eighth decade had higher hs-cTnI (p<0.05) than those in sixth decade within each ethnicity–gender subgroup. Of significant associations, age had the greatest impact on hs-cTnI followed by gender and then ethnicity.

Conclusion We report white–SA differences in hs-cTnI in men and a similar trend in women. We confirm age and gender differences in hs-cTnI, irrespective of ethnicity. Further studies are required to determine whether ethnicity-specific age and gender 99th percentile URLs improve detection or exclusion of myocardial injury.

  • cardiovascular diseases
  • chemistry
  • clinical
  • heart

Data availability statement

Data are available upon reasonable request.

https://doi.org/10.1136/jclinpath-2020-206951

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    Data availability statement

    Data are available upon reasonable request.

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    Footnotes

    • Handling editor Tahir S Pillay.

    • Contributors CF, NH, HS-C and RG designed the service evaluation. HS, RV, UA and SSM identified samples, anonymised samples and collected data. NH analysed the samples and compiled the data with help from HS-C and DC-G. TRK analysed the data and wrote first draft of the manuscript. All authors critically reviewed the manuscript and approved the final version.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.