|
| Study | Year | Patients | Women (%) | Cut-off applied (ng/L) | Comments |
| Men | Women |
|
| hs-cTnT (Roche Diagnostics) | | | | |
|
| Mueller-Hennessen et al. [92] | 2016 | 1282 | 477 (37%) | 15.5 | 9.0 | Sex-specific cut-offs increased MI diagnosis in women (from 17% to 23%) but this did not affect outcomes |
|
| | | | | 15.5 | 9.0 | Reclassification occurred in only 3 patients; no effects on outcomes. Tested three different sets of sex-specific cut-offs |
| Rubini Gimenez et al. [91] | 2016 | 2734 | 876 (32%) | 17.0 | 9.0 |
| | | | | 12.0 | 16.0 |
|
| | | | | 16.0 | 9.0 | Using sex-specific cut-offs, the prevalence of MI would increase by 3.3% in women. Sex-specific cut-offs did not improve risk prediction, but the study identified an increase of risk in women starting at 10-12 ng/L instead of 14 ng/L. |
| Eggers et al. [93] | 2016 | 57556 | 22027 (38%) | 26.0 | 15.0 |
| | | | | 34.0 | 24.0 |
|
| Mueller et al. [99] | 2018 | 3588 | 1643 (46%) | 16 | 9 | Sex-specific cut-offs increased myocardial injury diagnosis in 11% of women compared to a 4% decrease in men |
|
| McRae et al. [94] | 2018 | 7130 | 3199 (45%) | Several combinations according to sex | Implementation of sex-specific cut-offs improved specificity of hs-cTnT in the diagnostic approach of ACS |
|
| Yang et al. [95] | 2016 | 812 | 376 (46%) | Several according to age and sex | Sex-specific cut-offs were calculated in a healthy Chinese cohort and further stratified for age |
|
| hs-cTnI (Abbott Diagnostics) | | | | |
|
| Shah et al. [96] | 2018 | 48282 | 22562 (47%) | 34 | 16 | Sex-specific cut-offs for an hs-cTnI assay, compared to a contemporary cTnI assay, led to a two-fold myocardial injury reclassification rate in women; no difference in 1-year outcomes among reclassified patients treated according to cTnI vs hs-cTnI levels |
|
| Shah et al. [98] | 2015 | 1126 | 504 (45%) | 34 | 16 | Sex-specific cut-offs increase MI diagnosis in women (from 16 to 22%) while having small effects on men |
|
| Mueller et al. [99] | 2018 | 3588 | 1643 (46%) | 34 | 16 | Sex-specific cut-offs increased myocardial injury diagnosis in 6% of women compared to a 3% decrease in men |
|
| Cullen et al. [97] | 2016 | 2841 | 1180 (41%) | 34 | 16 | Small amount of women and men reclassified using sex-specific thresholds, thus improving identification of women at long-term (1 year) risk for MACE |
|
| Eggers et al. [100] | 2014 | 2750 | 1073 (39%) | 24.8 | 16.6 | Sex-specific cut-offs were derived from a reference population recruited for the purposes of the study. Sex-specific cut-offs did not show improvement in the identification of more at-risk patients; however higher concentrations of troponins show stronger predictive value in women than men |
|
| Bohula May et al. [101] | 2014 | 4695 | 1460 (31%) | 34 | 16 | Population presenting with typical ischemic symptoms. Using sex-specific thresholds, only 6 patients were reclassified; no improvement in prognostic performance. |
|
