Prognostic Value of High-Sensitivity Cardiac Troponin in Women
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-spe...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Biomolecules |
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| Online Access: | https://www.mdpi.com/2218-273X/12/10/1496 |
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| author | Giandomenico Bisaccia Fabrizio Ricci Mohammed Y. Khanji Giulia Gaggi Andrea Di Credico Sabina Gallina Angela Di Baldassarre Barbara Ghinassi |
| author_facet | Giandomenico Bisaccia Fabrizio Ricci Mohammed Y. Khanji Giulia Gaggi Andrea Di Credico Sabina Gallina Angela Di Baldassarre Barbara Ghinassi |
| author_sort | Giandomenico Bisaccia |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-03-09T20:37:28Z |
| format | Article |
| id | doaj.art-f4db06b916564bde9f7f4e1f2f2b4cb0 |
| institution | Directory Open Access Journal |
| issn | 2218-273X |
| language | English |
| last_indexed | 2024-03-09T20:37:28Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Biomolecules |
| spelling | doaj.art-f4db06b916564bde9f7f4e1f2f2b4cb02023-11-23T23:09:35ZengMDPI AGBiomolecules2218-273X2022-10-011210149610.3390/biom12101496Prognostic Value of High-Sensitivity Cardiac Troponin in WomenGiandomenico Bisaccia0Fabrizio Ricci1Mohammed Y. Khanji2Giulia Gaggi3Andrea Di Credico4Sabina Gallina5Angela Di Baldassarre6Barbara Ghinassi7MIUR Department of Excellence, Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via Luigi Polacchi, 66100 Chieti, ItalyMIUR Department of Excellence, Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via Luigi Polacchi, 66100 Chieti, ItalyNewham University Hospital, Barts Health NHS Trust, Glen Road, Plaistow, London E13 8SL, UKReprogramming and Cell Differentiation Lab, Center for Advanced Studies and Technology (CAST), 66100 Chieti, ItalyReprogramming and Cell Differentiation Lab, Center for Advanced Studies and Technology (CAST), 66100 Chieti, ItalyMIUR Department of Excellence, Department of Neuroscience, Imaging and Clinical Sciences, University “G. d’Annunzio” of Chieti-Pescara, Via Luigi Polacchi, 66100 Chieti, ItalyReprogramming and Cell Differentiation Lab, Center for Advanced Studies and Technology (CAST), 66100 Chieti, ItalyReprogramming and Cell Differentiation Lab, Center for Advanced Studies and Technology (CAST), 66100 Chieti, ItalyHigh-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.https://www.mdpi.com/2218-273X/12/10/1496cardiac troponinsprognosiscardiovascular diseasecardiovascular preventionsex differenceswomen’s health |
| spellingShingle | Giandomenico Bisaccia Fabrizio Ricci Mohammed Y. Khanji Giulia Gaggi Andrea Di Credico Sabina Gallina Angela Di Baldassarre Barbara Ghinassi Prognostic Value of High-Sensitivity Cardiac Troponin in Women Biomolecules cardiac troponins prognosis cardiovascular disease cardiovascular prevention sex differences women’s health |
| title | Prognostic Value of High-Sensitivity Cardiac Troponin in Women |
| title_full | Prognostic Value of High-Sensitivity Cardiac Troponin in Women |
| title_fullStr | Prognostic Value of High-Sensitivity Cardiac Troponin in Women |
| title_full_unstemmed | Prognostic Value of High-Sensitivity Cardiac Troponin in Women |
| title_short | Prognostic Value of High-Sensitivity Cardiac Troponin in Women |
| title_sort | prognostic value of high sensitivity cardiac troponin in women |
| topic | cardiac troponins prognosis cardiovascular disease cardiovascular prevention sex differences women’s health |
| url | https://www.mdpi.com/2218-273X/12/10/1496 |
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