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Clinical Chemistry 50: 1477-1479, 2004; 10.1373/clinchem.2004.036129
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(Clinical Chemistry. 2004;50:1477-1479.)
© 2004 American Association for Clinical Chemistry, Inc.

Letters to the Editor

Serum 99th Percentile Reference Cutoffs for Seven Cardiac Troponin Assays

Fred S. Applea and MaryAnn M. Murakami

Hennepin County Medical Center, University of Minnesota, School of Medicine, Department of Laboratory Medicine, and Pathology, Minneapolis, MN

aAddress correspondence to this author at: Hennepin County Medical Center, Clinical Laboratories P4, 701 Park Ave., Minneapolis, MN 55415. Fax 612-904-4229; e-mail fred.apple@co.hennepin.mn.us.

The first 20% of the full text of this article appears below.


To the Editor:

Several international expert panels, including the European Society of Cardiology, the American College of Cardiology, American Heart Association, the IFCC, the COURAGE trials group, the Italian Federation of Cardiology, and the American Heart Association and World Heart Federation Councils on Epidemiology and Prevention, have endorsed the concept that increased cardiac troponin I or T (cTnI or cTnT) should be defined as a measurement above the 99th percentile concentration of a reference population (1)(2)(3)(4)(5)(6)(7). Furthermore, an increased cTnI or cTnT value is considered indicative of myocardial injury (cell death) and, in the clinical setting of ischemia, is considered evidence of myocardial infarction and a high-risk profile for adverse cardiac and noncardiac events.

Previously, work from our laboratory reported on heparin plasma 99th percentile reference limits for both cTnT and seven cTnI assays (8). However, because heparin plasma is known to cause a negative . . . [Full Text of this Article]




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