Impact of age on cardiac troponin concentration among healthy individuals

Rasmus Bo Hasselbalch; Nina Strandkjær; Jonas Kristensen; Nicoline Jørgensen; Thilde Olivia Kock; Theis Lange; Sisse Rye Ostrowski; Janna Nissen; Margit Hørup Larsen; Ole Birger Vesterager Pedersen; Mustafa Vakur Bor; Shoaib Afzal; Pia Rørbæk Kamstrup; Morten Dahl; Linda Hilsted; Line Rode; Niklas Rye Jørgensen; Christian Torp-Pedersen; Henning Bundgaard; Kasper Karmark Iversen

doi:10.1016/j.clinbiochem.2025.110956

Impact of age on cardiac troponin concentration among healthy individuals

Rasmus Bo Hasselbalch^*, Nina Strandkjær, Jonas Kristensen, Nicoline Jørgensen, Thilde Olivia Kock, Theis Lange, Sisse Rye Ostrowski, Janna Nissen, Margit Hørup Larsen, Ole Birger Vesterager Pedersen, Mustafa Vakur Bor, Shoaib Afzal, Pia Rørbæk Kamstrup, Morten Dahl, Linda Hilsted, Line Rode, Niklas Rye Jørgensen, Christian Torp-Pedersen, Henning Bundgaard, Kasper Karmark Iversen

^*Corresponding author af dette arbejde

Abstract

BACKGROUND: The 99th percentile of cardiac troponin (cTn) among healthy individuals is the diagnostic cutoff for myocardial infarction. This study investigates the effect of age on the 99th percentile of cTn among healthy individuals.

METHODS: We sampled healthy Danish blood donors, screened using hemoglobin A1c, N-terminal pro-brain natriuretic peptide, and creatinine. The cTn assays investigated were Siemens Atellica and Dimension Vista hs-cTnI, Abbott hs-cTnI, Vitros hs-cTnI, and Roche hs-cTnT. The 99th percentiles were calculated using the non-parametric method and modeled using quantile regressions adjusted for sex and creatinine concentration.

RESULTS: We included 2287 participants, excluding 118 due to a history of heart disease, insufficient plasma, or biomarker screening, leaving 2169 participants with a median age of 58 years (IQR 49-69 years), and 1152 (53 %) were female. Concentrations increased with age for all assays (p < 0.001). Only the 99th percentile of hs-cTnT was significantly associated with age (0.42 ng/L increase/year, p < 0.001); for participants >70 years, the 99th percentile was 36.8 ng/L (90 % CI 33.8-40.7 ng/L), with 22.2 % above the manufacturer's 99th percentile. The difference in the 99th percentile between age groups was less clear for cTnI, except for the Vitros assay: <50 years 6.5 ng/L (90 % CI 5.0-26.9 ng/L) vs >70 years 17.3 ng/L (90 % CI 9.7-33.2 ng/L).

CONCLUSIONS: Age was associated with increased cTn concentrations for all assays. The correlation was strongest for hs-cTnT, where the 99th percentile for participants >70 years was more than double compared to those <50 years, with over 20 % exceeding the manufacturer's 99th percentile.

REGISTRATION: URL: https://www.

CLINICALTRIALS: gov; Unique identifier: NCT05336435.

Originalsprog	Engelsk
Artikelnummer	110956
Tidsskrift	Clinical Biochemistry
Vol/bind	138
Sider (fra-til)	110956
ISSN	0009-9120
DOI	https://doi.org/10.1016/j.clinbiochem.2025.110956
Status	Udgivet - aug. 2025

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10.1016/j.clinbiochem.2025.110956Licens: CC BY

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Hasselbalch, R. B., Strandkjær, N., Kristensen, J., Jørgensen, N., Kock, T. O., Lange, T., Ostrowski, S. R., Nissen, J., Larsen, M. H., Vesterager Pedersen, O. B., Bor, M. V., Afzal, S., Kamstrup, P. R., Dahl, M., Hilsted, L., Rode, L., Jørgensen, N. R., Torp-Pedersen, C., Bundgaard, H., & Iversen, K. K. (2025). Impact of age on cardiac troponin concentration among healthy individuals. Clinical Biochemistry, 138, 110956. Artikel 110956. https://doi.org/10.1016/j.clinbiochem.2025.110956

Hasselbalch, RB, Strandkjær, N , Kristensen, J, Jørgensen, N, Kock, TO, Lange, T, Ostrowski, SR , Nissen, J, Larsen, MH, Vesterager Pedersen, OB, Bor, MV, Afzal, S , Kamstrup, PR, Dahl, M, Hilsted, L , Rode, L , Jørgensen, NR , Torp-Pedersen, C , Bundgaard, H & Iversen, KK 2025, 'Impact of age on cardiac troponin concentration among healthy individuals', Clinical Biochemistry, bind 138, 110956, s. 110956. https://doi.org/10.1016/j.clinbiochem.2025.110956

@article{8242b38a9e0b4402a0a25a0042863adb,

title = "Impact of age on cardiac troponin concentration among healthy individuals",

abstract = "BACKGROUND: The 99th percentile of cardiac troponin (cTn) among healthy individuals is the diagnostic cutoff for myocardial infarction. This study investigates the effect of age on the 99th percentile of cTn among healthy individuals.METHODS: We sampled healthy Danish blood donors, screened using hemoglobin A1c, N-terminal pro-brain natriuretic peptide, and creatinine. The cTn assays investigated were Siemens Atellica and Dimension Vista hs-cTnI, Abbott hs-cTnI, Vitros hs-cTnI, and Roche hs-cTnT. The 99th percentiles were calculated using the non-parametric method and modeled using quantile regressions adjusted for sex and creatinine concentration.RESULTS: We included 2287 participants, excluding 118 due to a history of heart disease, insufficient plasma, or biomarker screening, leaving 2169 participants with a median age of 58 years (IQR 49-69 years), and 1152 (53 %) were female. Concentrations increased with age for all assays (p < 0.001). Only the 99th percentile of hs-cTnT was significantly associated with age (0.42 ng/L increase/year, p < 0.001); for participants >70 years, the 99th percentile was 36.8 ng/L (90 % CI 33.8-40.7 ng/L), with 22.2 % above the manufacturer's 99th percentile. The difference in the 99th percentile between age groups was less clear for cTnI, except for the Vitros assay: <50 years 6.5 ng/L (90 % CI 5.0-26.9 ng/L) vs >70 years 17.3 ng/L (90 % CI 9.7-33.2 ng/L).CONCLUSIONS: Age was associated with increased cTn concentrations for all assays. The correlation was strongest for hs-cTnT, where the 99th percentile for participants >70 years was more than double compared to those <50 years, with over 20 % exceeding the manufacturer's 99th percentile.REGISTRATION: URL: https://www.CLINICALTRIALS: gov; Unique identifier: NCT05336435.",

author = "Hasselbalch, {Rasmus Bo} and Nina Strandkj{\ae}r and Jonas Kristensen and Nicoline J{\o}rgensen and Kock, {Thilde Olivia} and Theis Lange and Ostrowski, {Sisse Rye} and Janna Nissen and Larsen, {Margit H{\o}rup} and {Vesterager Pedersen}, {Ole Birger} and Bor, {Mustafa Vakur} and Shoaib Afzal and Kamstrup, {Pia R{\o}rb{\ae}k} and Morten Dahl and Linda Hilsted and Line Rode and J{\o}rgensen, {Niklas Rye} and Christian Torp-Pedersen and Henning Bundgaard and Iversen, {Kasper Karmark}",

year = "2025",

month = aug,

doi = "10.1016/j.clinbiochem.2025.110956",

language = "English",

volume = "138",

pages = "110956",

journal = "Clinical Biochemistry",

issn = "0009-9120",

publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Impact of age on cardiac troponin concentration among healthy individuals

AU - Hasselbalch, Rasmus Bo

AU - Strandkjær, Nina

AU - Kristensen, Jonas

AU - Jørgensen, Nicoline

AU - Kock, Thilde Olivia

AU - Lange, Theis

AU - Ostrowski, Sisse Rye

AU - Nissen, Janna

AU - Larsen, Margit Hørup

AU - Vesterager Pedersen, Ole Birger

AU - Bor, Mustafa Vakur

AU - Afzal, Shoaib

AU - Kamstrup, Pia Rørbæk

AU - Dahl, Morten

AU - Hilsted, Linda

AU - Rode, Line

AU - Jørgensen, Niklas Rye

AU - Torp-Pedersen, Christian

AU - Bundgaard, Henning

AU - Iversen, Kasper Karmark

PY - 2025/8

Y1 - 2025/8

N2 - BACKGROUND: The 99th percentile of cardiac troponin (cTn) among healthy individuals is the diagnostic cutoff for myocardial infarction. This study investigates the effect of age on the 99th percentile of cTn among healthy individuals.METHODS: We sampled healthy Danish blood donors, screened using hemoglobin A1c, N-terminal pro-brain natriuretic peptide, and creatinine. The cTn assays investigated were Siemens Atellica and Dimension Vista hs-cTnI, Abbott hs-cTnI, Vitros hs-cTnI, and Roche hs-cTnT. The 99th percentiles were calculated using the non-parametric method and modeled using quantile regressions adjusted for sex and creatinine concentration.RESULTS: We included 2287 participants, excluding 118 due to a history of heart disease, insufficient plasma, or biomarker screening, leaving 2169 participants with a median age of 58 years (IQR 49-69 years), and 1152 (53 %) were female. Concentrations increased with age for all assays (p < 0.001). Only the 99th percentile of hs-cTnT was significantly associated with age (0.42 ng/L increase/year, p < 0.001); for participants >70 years, the 99th percentile was 36.8 ng/L (90 % CI 33.8-40.7 ng/L), with 22.2 % above the manufacturer's 99th percentile. The difference in the 99th percentile between age groups was less clear for cTnI, except for the Vitros assay: <50 years 6.5 ng/L (90 % CI 5.0-26.9 ng/L) vs >70 years 17.3 ng/L (90 % CI 9.7-33.2 ng/L).CONCLUSIONS: Age was associated with increased cTn concentrations for all assays. The correlation was strongest for hs-cTnT, where the 99th percentile for participants >70 years was more than double compared to those <50 years, with over 20 % exceeding the manufacturer's 99th percentile.REGISTRATION: URL: https://www.CLINICALTRIALS: gov; Unique identifier: NCT05336435.

AB - BACKGROUND: The 99th percentile of cardiac troponin (cTn) among healthy individuals is the diagnostic cutoff for myocardial infarction. This study investigates the effect of age on the 99th percentile of cTn among healthy individuals.METHODS: We sampled healthy Danish blood donors, screened using hemoglobin A1c, N-terminal pro-brain natriuretic peptide, and creatinine. The cTn assays investigated were Siemens Atellica and Dimension Vista hs-cTnI, Abbott hs-cTnI, Vitros hs-cTnI, and Roche hs-cTnT. The 99th percentiles were calculated using the non-parametric method and modeled using quantile regressions adjusted for sex and creatinine concentration.RESULTS: We included 2287 participants, excluding 118 due to a history of heart disease, insufficient plasma, or biomarker screening, leaving 2169 participants with a median age of 58 years (IQR 49-69 years), and 1152 (53 %) were female. Concentrations increased with age for all assays (p < 0.001). Only the 99th percentile of hs-cTnT was significantly associated with age (0.42 ng/L increase/year, p < 0.001); for participants >70 years, the 99th percentile was 36.8 ng/L (90 % CI 33.8-40.7 ng/L), with 22.2 % above the manufacturer's 99th percentile. The difference in the 99th percentile between age groups was less clear for cTnI, except for the Vitros assay: <50 years 6.5 ng/L (90 % CI 5.0-26.9 ng/L) vs >70 years 17.3 ng/L (90 % CI 9.7-33.2 ng/L).CONCLUSIONS: Age was associated with increased cTn concentrations for all assays. The correlation was strongest for hs-cTnT, where the 99th percentile for participants >70 years was more than double compared to those <50 years, with over 20 % exceeding the manufacturer's 99th percentile.REGISTRATION: URL: https://www.CLINICALTRIALS: gov; Unique identifier: NCT05336435.

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U2 - 10.1016/j.clinbiochem.2025.110956

DO - 10.1016/j.clinbiochem.2025.110956

M3 - Journal article

C2 - 40513714

SN - 0009-9120

VL - 138

SP - 110956

JO - Clinical Biochemistry

JF - Clinical Biochemistry

M1 - 110956

ER -

Impact of age on cardiac troponin concentration among healthy individuals

Abstract

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