Cardiac Troponin Reporting in Children and Young Adults: Time to Change Clinical Practice

HomeCirculationVol. 148, No. 1Cardiac Troponin Reporting in Children and Young Adults: Time to Change Clinical Practice No AccessEditorialRequest AccessFull TextAboutView Full TextView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toNo AccessEditorialRequest AccessFull TextCardiac Troponin Reporting in Children and Young Adults: Time to Change Clinical Practice Kristin M. Aakre, Steven J.R. Meex and Nicholas L. Mills Kristin M. AakreKristin M. Aakre Correspondence to: Kristin Moberg Aakre, MD, PhD, Department of Medical Biochemistry and Pharmacology, Postbox 1400, Haukeland University Hospital, 5021 Bergen, Norway. Email E-mail Address: [email protected] https://orcid.org/0000-0002-7340-6736 Department of Medical Biochemistry and Pharmacology & Department of Heart Disease, Haukeland University Hospital, Bergen, Norway (K.M.A.). Department of Clinical Science, University of Bergen, Norway (K.M.A.). Search for more papers by this author , Steven J.R. MeexSteven J.R. Meex Central Diagnostic Laboratory, Maastricht University Medical Center, the Netherlands (S.J.R.M.). CARIM School for Cardiovascular Diseases, Maastricht University, the Netherlands (S.J.R.M.). Search for more papers by this author and Nicholas L. MillsNicholas L. Mills https://orcid.org/0000-0003-0533-7991 BHF Centre for Cardiovascular Science (N.L.M.), University of Edinburgh, UK. Usher Institute (N.L.M.), University of Edinburgh, UK. Search for more papers by this author Originally published3 Jul 2023https://doi.org/10.1161/CIRCULATIONAHA.123.065297Circulation. 2023;148:17–19This article is a commentary on the followingMyocardial Injury Thresholds for 4 High-Sensitivity Troponin Assays in a Population-Based Sample of US Children and AdolescentsFootnotesThe opinions expressed in this article are not necessarily those of the editors or of the American Heart Association.Circulation is available at www.ahajournals.org/journal/circFor Disclosures, see page 19.Correspondence to: Kristin Moberg Aakre, MD, PhD, Department of Medical Biochemistry and Pharmacology, Postbox 1400, Haukeland University Hospital, 5021 Bergen, Norway. Email kristin.moberg.aakre@helse-bergen.noReferences1. Park KC, Gaze DC, Collinson PO, Marber MS. Cardiac troponins: from myocardial infarction to chronic disease.Cardiovasc Res. 2017; 113:1708–1718. doi: 10.1093/cvr/cvx183CrossrefMedlineGoogle Scholar2. Thygesen K, Alpert JS, Jaffe AS, Chaitman BR, Bax JJ, Morrow DA, White HD; Executive Group on behalf of the Joint European Society of Cardiology (ESC)/American College of Cardiology (ACC)/American Heart Association (AHA)/World Heart Federation (WHF) Task Force for the Universal Definition of Myocardial Infarction. Fourth universal definition of myocardial infarction.Circulation. 2018; 138:e618–e651. doi: 10.1161/CIR.0000000000000617LinkGoogle Scholar3. Apple FS, Wu AHB, Sandoval Y, Sexter A, Love SA, Myers G, Schulz K, Duh S, Christenson RH. Sex-specific 99th percentile upper reference limits for high sensitivity cardiac troponin assays derived using a universal sample bank.Clin Chem. 2020; 66:434–444. doi: 10.1093/clinchem/hvz029CrossrefMedlineGoogle Scholar4. Wang A, Sandoval Y, Apple FS, Homme J, Jaffe AS; IFCC Committee on Clinical Applications of Cardiac Bio-Markers. IFCC committee on clinical applications of cardiac bio-markers: the need to develop clinical guidance for the use of high-sensitivity cardiac troponin in pediatric and neonatal patients.Clin Chem. 2022; 68:884–886. doi: 10.1093/clinchem/hvac072CrossrefMedlineGoogle Scholar5. Patone M, Mei XW, Handunnetthi L, Dixon S, Zaccardi F, Shankar-Hari M, Watkinson P, Khunti K, Harnden A, Coupland CAC, et al. Risk of myocarditis after sequential doses of COVID-19 vaccine and SARS-CoV-2 infection by age and sex.Circulation. 2022; 146:743–754. doi: 10.1161/CIRCULATIONAHA.122.059970LinkGoogle Scholar6. Alpert JS, Thygesen K, Antman E, Bassand JP. Myocardial infarction redefined: a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction.J Am Coll Cardiol. 2000; 36:959–969. doi: 10.1016/s0735-1097(00)00804-4CrossrefMedlineGoogle Scholar7. Welsh P, Preiss D, Shah ASV, McAllister D, Briggs A, Boachie C, McConnachie A, Hayward C, Padmanabhan S, Welsh C, et al. Comparison between high-sensitivity cardiac troponin T and cardiac troponin I in a large general population cohort.Clin Chem. 2018; 64:1607–1616. doi: 10.1373/clinchem.2018.292086CrossrefMedlineGoogle Scholar8. Aakre KM, Saenger AK, Body R, Collinson P, Hammarsten O, Jaffe AS, Kavsak P, Omland T, Ordonez-Lianos J, Apple FS. Analytical considerations in deriving 99th percentile upper reference limits for high-sensitivity cardiac troponin assays: educational recommendations from the IFCC committee on clinical application of cardiac bio-markers.Clin Chem. 2022; 68:1022–1030. doi: 10.1093/clinchem/hvac092CrossrefMedlineGoogle Scholar9. de Bakker M, Anand A, Shipley M, Fujisawa T, Shah ASV, Kardys I, Boersma E, Brunner EJ, Mills NL, Kimenai DM. Sex differences in cardiac troponin trajectories over the life course [published online April 28, 2023]. Circulation. doi: 10.1161/CIRCULATIONAHA.123.064386LinkGoogle Scholar10. Kavsak PA, Rezanpour A, Chen Y, Adeli K. Assessment of the 99th or 97.5th percentile for cardiac troponin I in a healthy pediatric cohort.Clin Chem. 2014; 60:1574–1576. doi: 10.1373/clinchem.2014.228619CrossrefMedlineGoogle Scholar11. McEvoy JW, Wang D, Brady T, Tang O, Ndumele CE, Coresh J, Christenson RH, Selvin E. Myocardial injury thresholds for 4 high-sensitivity troponin assays in a population-based sample of US children and adolescents.Circulation. 2023; 148:7–16. doi: 10.1161/CIRCULATIONAHA.122.063281LinkGoogle Scholar12. Kimenai DM, Janssen EBNJ, Eggers KM, Lindahl B, den Ruijter HM, Bekers O, Appelman Y, Meex SJR. Sex-specific versus overall clinical decision limits for cardiac troponin I and T for the diagnosis of acute myocardial infarction: a systematic review.Clin Chem. 2018; 64:1034–1043. doi: 10.1373/clinchem.2018.286781CrossrefMedlineGoogle Scholar13. Kiess A, Green J, Willenberg A, Ceglarek U, Dahnert I, Jurkutat A, Korner A, Hiemisch A, Kiess W, Vogel M. Age-dependent reference values for hs-troponin T and NT-proBNP and determining factors in a cohort of healthy children (the LIFE Child Study).Pediatr Cardiol. 2022; 43:1071–1083. doi: 10.1007/s00246-022-02827-xCrossrefMedlineGoogle Scholar14. Dionne A, Kheir JN, Sleeper LA, Esch JJ, Breitbart RE. Value of troponin testing for detection of heart disease in previously healthy children.J Am Heart Assoc. 2020; 9:e012897. doi: 10.1161/JAHA.119.012897LinkGoogle Scholar eLetters(0)eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate.Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page.Sign In to Submit a Response to This Article Previous Back to top Next FiguresReferencesRelatedDetailsRelated articlesMyocardial Injury Thresholds for 4 High-Sensitivity Troponin Assays in a Population-Based Sample of US Children and AdolescentsJohn W. McEvoy, et al. Circulation. 2023;148:7-16 July 4, 2023Vol 148, Issue 1 Advertisement Article InformationMetrics © 2023 American Heart Association, Inc.https://doi.org/10.1161/CIRCULATIONAHA.123.065297PMID: 37399263 Originally publishedJuly 3, 2023 KeywordschildEditorialsheart diseasetroponinadolescentreference valuesPDF download Advertisement SubjectsBiomarkersClinical StudiesDiagnostic TestingPrognosisVascular Disease