ArticleClinical chemistry and laboratory medicine2025
Evaluation of sex-specific 0-h high-sensitivity cardiac troponin T thresholds for the risk stratification of non-ST-segment elevation myocardial infarction.
Article in Clinical chemistry and laboratory medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Clinical Gray Zones of Cardiac Troponin Interpretation in the Emergency Department: When Increased Concentrations Do Not Equal Acute Coronary Syndrome.Journal of clinical medicine · 2026Review
- Diagnostic and therapeutic innovations in myocardial infarction: a focus on mitochondrial dysfunction.Frontiers in cardiovascular medicine · 2026Review
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Authors and funding
9 authors.
Funding
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Abstract
objectivesWe aimed to evaluate sex-specific 0-h high-sensitivity cardiac troponin T (hs-cTnT) thresholds for risk stratification in patients with suspected non-ST-segment elevation myocardial infarction (NSTEMI).
methodsThis retrospective study investigated a derivation cohort of 6,691 (44.4 % female and aged 65 (57-72) years) and a validation cohort of 6,589 (48.4 % female and aged 63 (50-71) years) patients with suspected NSTEMI who visited the emergency department. Uniform and sex-specific thresholds were derived and validated, and their performances were compared.
resultsIn the derivation cohort, 11.3 % of males and 5.4 % of females were diagnosed with adjudicated NSTEMI. As male-specific thresholds, 0-h hs-cTnT <10 ng/L ruled out 30.1 % of patients with an NPV of 99.6 % [95 % CI (99.0-99.9 %)], and 0-h hs-cTnT ≥65 ng/L ruled in 12.3 % of patients with a PPV of 70.5 % [95 % CI (66.0-74.6 %)]. As female-specific thresholds, 0-h hs-cTnT <9 ng/L ruled out 39.2 % of patients with an NPV of 99.9 % [95 % CI (99.4-100.0 %)], and 0-h hs-cTnT ≥45 ng/L ruled in 6.7 % of patients with a PPV of 71.7 % [95 % CI (64.8-77.8 %)]. The validation cohort showed similar results. Sex-specific and uniform thresholds did not significantly affect rule-in performance, whereas sex-specific thresholds increased female sensitivity by 1 % (99.7 vs. 98.7 %). Patient follow-up did not change when sex-specific thresholds were applied.
conclusionsSex-specific 0-h hs-cTnT thresholds could slightly improve the safety in ruling out NSTEMI in females, but their role in terms of efficiency, rule-in performance and prognosis was similar to that of uniform thresholds.
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