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

Background: There is interest in utilizing different cut-offs per sex for high-sensitivity cardiac troponin 1 (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 hscTnT = 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.