Table 5.
The 99th and 95th percentiles of high-sensitivity cardiac troponin T (hsTnT) and percentiles corresponding to the recommended rule-out cut-off for non-ST segment elevation myocardial infarction (14 ng/L)
| n | 99th hsTnT percentile (95% CI) | 95th hsTnT percentile (95% CI) | Proportion below hsTnT 14 ng/L | |
| All | 1129 | 54 (44 to 74) | 29 (26 to 31) | 68 |
| Stratified by sex | ||||
| Women | 509 | 38 (27 to 79) | 22 (20 to 23) | 82 |
| Men | 620 | 64 (46 to 102)*† | 31 (29 to 36)*¶ | 57 |
| Stratified by sex and age | ||||
| Women 70–79 years | 375 | 29 (23 to 58) | 19 (15 to 21) | 88 |
| Women 80–95 years | 134 | 67 (39 to 79) | 27 (22 to 39) | 66 |
| Men 70–79 years | 433 | 70 (42 to 281)*‡ | 30 (26 to 33)*** | 67 |
| Men 80–95 years | 187 | 59 (52 to 75) | 37 (31 to 46) | 34 |
| Stratified by kidney function | ||||
| eGFR ≥60 | 778 | 33 (30 to 36) | 24 (22 to 26) | 76 |
| eGFR <60 | 338 | 77 (56 to 308)*§ | 44 (34 to 53)*†† | 50 |
| Subcohort I | ||||
| All | 618 | 32 (28 to 33) | 22 (21 to 25) | 79 |
| Stratified by sex | ||||
| Women | 289 | 25 (21 to 41) | 17 (15 to 20) | 90 |
| Men | 329 | 32 (30 to 33) | 25 (23 to 28) | 70 |
| Stratified by age group | ||||
| 70–79 years | 507 | 30 (26 to 33) | 21 (19 to 23) | 83 |
| 80–95 years | 111 | 40 (31 to 41) | 28 (23 to 32) | 62 |
| Subcohort II | ||||
| All | 366 | 31 (26 to 33) | 20 (17 to 23) | 83 |
| Stratified by sex | ||||
| Women | 173 | 22 (21 to 22) | 16 (14 to 20) | 90 |
| Men | 193 | 33 (31 to 33) | 25 (18 to 29) | 77 |
| Stratified by age group | ||||
| 70–79 years | 304 | 30 (22 to 33) | 18 (15 to 21) | 88 |
| 80–95 years | 62 | N/A | 29 (22 to 33) | 60 |
| Subcohort III | ||||
| All | 96 | N/A | 17 (14 to 25) | 90 |
| Stratified by sex | ||||
| Women | 49 | N/A | 17 (11 to 20) | 94 |
| Men | 47 | N/A | 23 (14 to 29) | 85 |
| Stratified by age group | ||||
| 70–79 years | 86 | N/A | 14 (12 to 20) | 94 |
| 80–95 years | 10 | N/A | N/A | 50 |
Shown are 99th and 95th percentiles with 95% CIs in the entire AugUR study sample (all) with further stratification for sex, age and renal function, as well as in subcohorts free of overt heart disease and impaired renal function (subcohort 1), comorbidities associated with elevated hsTnT (diabetes and obesity; subcohort 2) and subtle cardiovascular disease measurable by echocardiography (subcohort 3).
Subcohort I: subjects free of clinical coronary artery disease and heart failure with normal renal function (eGFR ≥60 mL/min/1.73 m2).
Subcohort II: as subcohort I, additionally free of diabetes and obesity (body mass index <30 kg/m2) with a blood pressure <160/100 mm Hg at study visit.
Subcohort III: as subcohort II, additionally in regular heart rhythm, free of left ventricular hypertrophy, of elevated left ventricular filling pressure (E/e’ >14) and of left ventricular systolic dysfunction (EF <50%).
Left ventricular hypertrophy: left ventricular mass to body surface area >115 g/m2 for men/95g/m2 for women.
*Leave-one-out analyses revealed an influential observation: one man (age 77 years, eGFR 59 mL/min/1.73 m2, no coronary artery disease, LVMi 117 g/m2, EF 65%) exhibited an extraordinarily elevated hsTnT level of 421 ng/L. Excluding it, percentiles and 95% CIs were lowered to †57 (46–75), ‡63 (38–101) and §74 (55–93) for the 99th percentiles in ng/L (95% CI) and ¶31 (30–33), **29 (26–33) and ††43 (33 – 49) for the 95th percentiles in ng/L (95% CI).
AugUR, Altersbezogene Untersuchungen zur Gesundheit der University of Regensburg; E/e′, ratio of the transmitral early peak velocity by pulsed wave Doppler over mean early diastolic velocity determined at the septal and lateral mitral annulus by tissue Doppler; EF, ejection fraction; eGFRcrea, glomerular filtration rate estimated from serum creatinine (mL/min/1.73 m2); hsTnT, high-sensitivity cardiac troponin T; LVMi, ratio of left ventricular mass to body surface area.