Division of Hematology/Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
CALIPER Program, Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada.
J Appl Lab Med. 2021 Mar 1;6(2):344-353. doi: 10.1093/jalm/jfaa090.
Cardiac troponin (cTn) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) are increasingly used clinically to evaluate and prognosticate acute myocardial infarction and heart failure, respectively. Pediatric reference intervals and cut-offs have not been established for Roche's Elecsys Troponin T hs (high sensitive) assay. Although pediatric reference intervals exist for NT-proBNP, cut-off values do not exist. In this study, we report reference intervals and 99th percentile cut-offs in a large, healthy Canadian pediatric population using the CALIPER cohort.
Blood samples from 484 healthy children and adolescents between 0 and <19 years old were recruited from hospital outpatient clinics and community settings. Serum samples were analyzed using Roche's Cobas e411 and evaluated for high-sensitivity cTnT (hs-cTnT) and NT-proBNP concentrations. 95% reference intervals and 99th percentile cut-off values were established.
Three hs-cTnT age partitions were established (0 to <6 months, 6 months to <1 year, and 1 to <19 years) with highest concentrations observed in children under 1 year. Two NT-proBNP age partitions were established (0 to <1 year, and 1 to <19 years), also with higher concentrations in infants under 1 year of age. For each of these age partitions, the 99th percentile cut-off, 95% reference interval, and proportion of detectable concentrations were determined.
This is the first study to examine hs-cTnT and NT-proBNP reference values together in a healthy pediatric cohort without other clinical indications. We present 99th percentile cut-offs, which will allow clinicians to appropriately evaluate cardiovascular disease in children and adolescents.
心肌肌钙蛋白（cTn）和 N 末端 pro-B 型利钠肽（NT-proBNP）分别越来越多地用于评估急性心肌梗死和心力衰竭，并预测其预后。罗氏 Elecsys Troponin T hs（高敏）检测法尚未建立儿科参考区间和截断值。虽然存在 NT-proBNP 的儿科参考区间，但不存在截断值。在这项研究中，我们使用 CALIPER 队列报告了一个大型加拿大健康儿科人群中的参考区间和 99 百分位截断值。
从医院门诊和社区环境中招募了 484 名 0 至<19 岁的健康儿童和青少年的血液样本。使用罗氏 Cobas e411 分析血清样本，并评估高敏肌钙蛋白 T（hs-cTnT）和 NT-proBNP 浓度。建立了 95%参考区间和 99%百分位截断值。
建立了 3 个 hs-cTnT 年龄分区（0 至<6 个月、6 个月至<1 岁和 1 至<19 岁），1 岁以下儿童的浓度最高。建立了 2 个 NT-proBNP 年龄分区（0 至<1 岁和 1 至<19 岁），1 岁以下婴儿的浓度也较高。对于每个年龄分区，确定了 99%百分位截断值、95%参考区间和可检测浓度的比例。
这是第一项在没有其他临床指征的情况下，在健康儿科人群中同时检查 hs-cTnT 和 NT-proBNP 参考值的研究。我们提出了 99%百分位截断值，这将使临床医生能够适当评估儿童和青少年的心血管疾病。
