Kavsak Peter A, Worster Andrew, Shortt Colleen, Ma Jinhui, Clayton Natasha, Sherbino Jonathan, Hill Stephen A, McQueen Matthew, Griffith Lauren, Mehta Shamir R, Devereaux P J
1 Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON, Canada.
2 Division of Emergency Medicine, McMaster University, Hamilton, ON, Canada.
Ann Clin Biochem. 2018 Sep;55(5):604-607. doi: 10.1177/0004563217743997. Epub 2017 Nov 23.
Background There is interest in utilizing different cut-offs per sex for high-sensitivity cardiac troponin I (hs-cTnI) but less so for high-sensitivity cardiac troponin T (hs-cTnT) for patient management in the acute setting. Our objective was to assess if differences in hs-cTn concentrations exist between males and females for an acute cardiac outcome following the presentation measurement in the emergency department. Methods An observational emergency department population with hs-cTn measurements (Roche Diagnostics and Abbott Diagnostics) at presentation with seven-day outcomes for a composite acute cardiac outcome (i.e. myocardial infarction, unstable angina, ventricular arrhythmia, heart failure or cardiovascular death) (ClinicalTrials.gov: NCT01994577). Receiver operating characteristic curve analyses were performed for each sex with both hs-cTn assays. Results In those patients who had a composite acute cardiac outcome ( n = 128 females; n = 145 males), there was no difference in hs-cTn concentrations between the sexes (median [IQR] female hs-cTnT = 35 ng/L [21-69] vs. male hs-cTnT = 38 ng/L [19-77], P = 0.95; and median [IQR] female hs-cTnI = 27 ng/L [12-75] vs. male hs-cTnI = 26 ng/L [12-85], P = 0.97]. There was also no difference in the area under the curve between the hs-cTn assays and between the sexes ( P > 0.10). Comparing hs-cTn concentrations in those patients with the composite outcome between the sexes <60 years and ≥60 years of age also did not yield significant differences ( P > 0.70). Conclusions The concentrations and area under the curves of hs-cTnT and hs-cTnI at patient presentation in the emergency department for an acute composite cardiac outcome were similar between the sexes in this exploratory study.
在急性情况下的患者管理中，人们有兴趣针对高敏心肌肌钙蛋白I（hs-cTnI）采用不同的性别临界值，但对于高敏心肌肌钙蛋白T（hs-cTnT）的关注较少。我们的目的是评估在急诊科就诊测量后，男性和女性之间hs-cTn浓度对于急性心脏结局是否存在差异。方法：对在急诊科就诊时进行hs-cTn测量（罗氏诊断和雅培诊断）的观察性人群进行研究，随访七天观察复合急性心脏结局（即心肌梗死、不稳定型心绞痛、室性心律失常、心力衰竭或心血管死亡）（ClinicalTrials.gov：NCT01994577）。对每种性别使用两种hs-cTn检测方法进行受试者工作特征曲线分析。结果：在发生复合急性心脏结局的患者中（n = 128名女性；n = 145名男性），性别之间的hs-cTn浓度无差异（女性hs-cTnT中位数[四分位间距] = 35 ng/L [21 - 69]，男性hs-cTnT = 38 ng/L [19 - 77]，P = 0.95；女性hs-cTnI中位数[四分位间距] = 27 ng/L [12 - 75]，男性hs-cTnI = 26 ng/L [12 - 85]，P = 0.97）。hs-cTn检测方法之间以及性别之间曲线下面积也无差异（P > 0.10）。比较年龄<60岁和≥60岁的发生复合结局患者的性别之间hs-cTn浓度也未产生显著差异（P > 0.70）。结论：在这项探索性研究中，急诊科患者就诊时针对急性复合心脏结局的hs-cTnT和hs-cTnI浓度及曲线下面积在性别之间相似。
