High-sensitivity cardiac troponin concentrations at emergency department presentation in females and males with an acute cardiac outcome

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.

Keywords: Cardiovascular death; acute coronary syndrome; emergency department; heart failure; high-sensitivity cardiac troponin; myocardial infarction; sex-specific cut-offs.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Emergency Service, Hospital
  • Female
  • Heart Diseases / diagnosis*
  • Humans
  • Limit of Detection
  • Male
  • Middle Aged
  • ROC Curve
  • Sex Factors
  • Troponin I / blood*
  • Troponin T / blood*


  • Troponin I
  • Troponin T

Associated data

  • ClinicalTrials.gov/NCT01994577