Selection of healthy reference populations and definition of exclusion criteria for deriving 99th percentiles for high-sensitivity cardiac troponin assays (hs-cTn) used in clinical practice and research vary considerably. Dr. Fred S. Apple and Dr. W. Frank Peacock discuss the following Universal Sample Bank findings and their clinical implications:
- Sex-specific 99th percentiles varied according to the statistical method and hs-cTn assay used
- Not all assays provided measurable concentrations for women to qualify as hs assays
- Surrogate exclusion criteria used to define normality tended to lower 99th percentiles.
Participants will learn that the decision concentrations used can affect diagnostics, risk-outcome assessments, and analytical characteristics.
AT THE END OF THIS ACTIVITY, PARTICIPANTS WILL BE ABLE TO:
- Identify sex-specific 99th percentiles variations according to the statistical method and hs-cTn assay used.
- Describe why not all assays provided measurable concentrations for women to qualify as hs assays.
- Summarize how and when surrogate exclusion criteria should be used to define normality.
Fred S. Apple, Ph.D. DABCC, FACSM (current)
Co-Medical Director, Clinical and Forensic Toxicology Laboratory, Hennepin Healthcare/Hennepin County Medical Center
Professor, Department of Laboratory Medicine and Pathology, University of Minnesota School of Medicine
W. Frank Peacock, MD, FACEP, FACC, FESC
Professor, Vice Chair for Research
Henry JN Taub Department of Emergency Medicine
Baylor College of Medicine
This activity is approved for 1.25 ACCENT® continuing education credits. Activity ID# 2000. This activity was planned in accordance with ACCENT® Standards and Policies.