Prognostic Value of High-Sensitivity Cardiac Troponin in Women
(2022) In Biomolecules 12(10).- Abstract
High-sensitivity cardiac troponin assays have become the gold standard for diagnosing acute and chronic myocardial injury. The detection of troponin levels beyond the 99th percentile is included in the fourth universal definition of myocardial infarction, specifically recommending the use of sex-specific thresholds. Measurable concentrations below the proposed diagnostic thresholds have been shown to inform prognosis in different categories of inpatients and outpatients. However, clinical investigations from the last twenty years have yielded conflicting results regarding the incremental value of using different cut-offs for men and women. While advocates of a sex-specific approach claim it may help reduce gender bias in cardiovascular... (More)
High-sensitivity cardiac troponin assays have become the gold standard for diagnosing acute and chronic myocardial injury. The detection of troponin levels beyond the 99th percentile is included in the fourth universal definition of myocardial infarction, specifically recommending the use of sex-specific thresholds. Measurable concentrations below the proposed diagnostic thresholds have been shown to inform prognosis in different categories of inpatients and outpatients. However, clinical investigations from the last twenty years have yielded conflicting results regarding the incremental value of using different cut-offs for men and women. While advocates of a sex-specific approach claim it may help reduce gender bias in cardiovascular medicine, particularly in acute coronary syndromes, other groups question the alleged incremental diagnostic and prognostic value of sex-specific thresholds, ultimately asserting that less is more. In the present review, we aimed to synthesize our current understanding of sex-based differences in cardiac troponin levels and to reappraise the available evidence with regard to (i) the prognostic significance of sex-specific diagnostic thresholds of high-sensitivity cardiac troponin assays compared to common cut-offs in both men and women undergoing cardiovascular disease risk assessment, and (ii) the clinical utility of high-sensitivity cardiac troponin assays for cardiovascular disease prevention in women.
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- author
- Bisaccia, Giandomenico ; Ricci, Fabrizio LU ; Khanji, Mohammed Y. ; Gaggi, Giulia ; Di Credico, Andrea ; Gallina, Sabina ; Di Baldassarre, Angela and Ghinassi, Barbara
- organization
- publishing date
- 2022
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- cardiac troponins, cardiovascular disease, cardiovascular prevention, prognosis, sex differences, women’s health
- in
- Biomolecules
- volume
- 12
- issue
- 10
- article number
- 1496
- publisher
- MDPI AG
- external identifiers
-
- scopus:85140434408
- pmid:36291705
- ISSN
- 2218-273X
- DOI
- 10.3390/biom12101496
- language
- English
- LU publication?
- yes
- id
- 2f22aa7d-5492-45f4-8d33-f8800a62ed33
- date added to LUP
- 2022-12-14 13:17:43
- date last changed
- 2024-05-26 15:12:47
@article{2f22aa7d-5492-45f4-8d33-f8800a62ed33,
abstract = {{<p>High-sensitivity cardiac troponin assays have become the gold standard for diagnosing acute and chronic myocardial injury. The detection of troponin levels beyond the 99th percentile is included in the fourth universal definition of myocardial infarction, specifically recommending the use of sex-specific thresholds. Measurable concentrations below the proposed diagnostic thresholds have been shown to inform prognosis in different categories of inpatients and outpatients. However, clinical investigations from the last twenty years have yielded conflicting results regarding the incremental value of using different cut-offs for men and women. While advocates of a sex-specific approach claim it may help reduce gender bias in cardiovascular medicine, particularly in acute coronary syndromes, other groups question the alleged incremental diagnostic and prognostic value of sex-specific thresholds, ultimately asserting that less is more. In the present review, we aimed to synthesize our current understanding of sex-based differences in cardiac troponin levels and to reappraise the available evidence with regard to (i) the prognostic significance of sex-specific diagnostic thresholds of high-sensitivity cardiac troponin assays compared to common cut-offs in both men and women undergoing cardiovascular disease risk assessment, and (ii) the clinical utility of high-sensitivity cardiac troponin assays for cardiovascular disease prevention in women.</p>}},
author = {{Bisaccia, Giandomenico and Ricci, Fabrizio and Khanji, Mohammed Y. and Gaggi, Giulia and Di Credico, Andrea and Gallina, Sabina and Di Baldassarre, Angela and Ghinassi, Barbara}},
issn = {{2218-273X}},
keywords = {{cardiac troponins; cardiovascular disease; cardiovascular prevention; prognosis; sex differences; women’s health}},
language = {{eng}},
number = {{10}},
publisher = {{MDPI AG}},
series = {{Biomolecules}},
title = {{Prognostic Value of High-Sensitivity Cardiac Troponin in Women}},
url = {{http://dx.doi.org/10.3390/biom12101496}},
doi = {{10.3390/biom12101496}},
volume = {{12}},
year = {{2022}},
}