Table 2: Studies reporting percentile values for hs-cTnI in different reference populations. †=median [IQR]; =only range provided; BMI: body mass index; BNP: brain natriuretic peptide; CI: confidence interval; cTn: cardiac troponin; eGFR: estimated glomerular filtration rate; HbA1c: glycated hemoglobin; US: United States.

StudyStudy objectiveYearLocationStudy populationAge, mean ± SDPopulation, according to sex percentile (ng/L) [95% CI]Comments
Males (%)Females (%)MalesFemales

hs-cTnI (Abbott Diagnostics)

Apple et al. [61]To systematically assess percentiles of cTn concentrations in a single population for a large number of assays2012US52418-64272 (52)252 (48)3615Reference population selection based only on health questionnaire interviews

Koerbin et al. [63]To assess analytical characteristics and to apply the assay to a population of apparently cardiovascular disease-free people2012Australia49720-84231 (46.5)266 (53.5)1411Reference population selection based on medical history and biomarkers

Aw et al. [85]To determine percentile reference values in a large Asian cohort2013Asia112050.4 ± 8.2597 (53.3)523 (46.7)32.717.9Reference population selection based on: medical history

Krintus et al. [27]To assess percentile for hs-cTnI in a large multicenter European cohort2015Europe176949 776 (43.9)993 (56.1)2711.4Reference population selection based on blood donors, health questionnaires and no overt cardiovascular disease

Omland et al. [86] To assess sex-related differences in hs-cTnI distribution across sexes2015Norway8099Males: 50.2 ± 17.13670 (45.3)4429 (54.7)34.8 [26.3-49.4]18.7 [14.8-23.1]Reference intervals are reported for women and men without history of major cardiovascular disease or risk factor
Females: 49.7 ± 16.4

Zeller et al. [87]To assess sex-specific percentile reference values in a large German-based cohort2015Germany413850 2098 (50.7)2040 (49.3)33.1 [28.3-45.8]19.9 [16.1-23.9]Reference population selection based on different criteria with several subgroups reported (here the overall)

1535 (whole cohort)57 ± 8733 (47.6)807 (52.4)20 []11 []Reference population selection based on: medical history and biomarkers; population stratified by age
Kimenai et al. [78]To assess sex-specific and age-specific percentile upper reference limits of hs-cTnT and hs-cTnI in a single reference cohort2016Netherlands28340-49120 (42.4)163 (57.6)13 []12 []
94450-64441 (46.7)503 (53.3)22 []9 []
30865-75168 (54.5)140 (45.6)20 []13 []

Mueller et al. [80]To assess percentile in a blood donors population2016Austria40235
259 (64.4)143 (35.6)39.023.5Reference population selection based on: no overt cardiovascular disease, eGFR > 90 ml/min

Ji et al. [88]To assess percentile values in a Korean cohort2016South Korea85449.8 ± 10.2426 (49.9)428 (50.1)2019Reference population selection based on clinical history and laboratory tests (eGFR, HbA1c, BNP)

Li et al. [89]To assess percentile for hs-cTnI in a Chinese-based population2017China148536 ± 13731 (49.2)754 (50.8)31.122.7Reference population selection based on: clinical history, BMI, renal function

Welsh et al. [108]Evaluating the influence of several variables, including sex, on the percentile levels of hs-cTnT and hs-cTnI2018Scotland1950135-658126 (41.7)11375 (58.3)Several according to ageSeveral according to ageReference population selection based on general population; health questionnaire; lab tests

hs-cTnI (Beckman Coulter)

Apple et al. [61]To systematically assess percentiles of cTn concentrations in a single population for a large number of assays2012US52418-64272 (52)252 (48)5223Reference population selection based only on health questionnaire interviews

hs-cTnI (Singulex)

Apple et al. [41]To determine percentile reference value for hs-cTnI assay2010US34818-76147 (42.2)201 (57.8)16.69.4Reference population selection based only on health questionnaire interviews

Bossard et al. [90]To assess factors related to hs-cTnI levels in a healthy young population without overt cardiovascular diseases2016Liechtenstein207736.7 975 (46.9)1102 (53.1)15.85.1Reference population selection based on: clinical records and absence of comorbidities

hs-cTnI (Siemens)

Apple et al. [61]To systematically assess percentiles of cTn troponin concentrations in a single population for a large number of assays2012US52418-64272 (52)252 (48)8142Reference population selection based only on health questionnaire interviews

McKie et al. [42]To define hs-cTnI reference values and determinants in the general community, in a healthy reference cohort, and in subsets with diseases2013US56554 [50-61260 (45)305 (54)55 []33 []Reference population selection based on medical history, biomarkers and cardiac imaging