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Absolute Versus Relative Changes in Cardiac Troponin T: Corresponding Cutoffs Based on Quantile Generalized Additive Models (QGAM)

Abstract : Background: The diagnosis of myocardial injury/infarction (MI) mainly relies on relative changes in cardiac troponin. However, absolute change cut-offs provide greater diagnostic sensitivity. We determined the absolute changes in high-sensitive cardiac troponin T concentrations (absΔhs-cTnT) corresponding to the main relative cut-offs (relΔhs-cTnT), using a quantile generalized additive model (qgam). Methods: Plasma Δhs-cTnT from patients selected with a time variation of 1 to 6 hours were collected over a 6-year period. The absΔhs-cTnT-to-relΔhs-cTnT relationship was fitted using qgam, after ordered quantile-based normalization (OQN) to reduce the influence of extreme values. Results: The qgam regression curve was nonlinear. Classifying patients (n=9753) above the recommended relΔhs-cTnT and predicted absΔhs-cTnT cut-offs as positive, the MI diagnosis rates were similar, and more reliable using the OQN-transformed data-based qgam, as compared to the untransformed data-based one. Conclusions: Through an optimized qgam-based approach accounting for heavy-tailed distributions, absolute Δhs-cTnT are provided for the corresponding relative Δhs-cTnT cut-offs.
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https://hal-cnrs.archives-ouvertes.fr/hal-03864166
Contributor : pascal bigey Connect in order to contact the contributor
Submitted on : Monday, November 21, 2022 - 4:42:52 PM
Last modification on : Thursday, November 24, 2022 - 4:05:21 AM

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Denis Monneret, Dominique Bonnefont-Rousselot, Matteo Fasiolo. Absolute Versus Relative Changes in Cardiac Troponin T: Corresponding Cutoffs Based on Quantile Generalized Additive Models (QGAM). Clinical Laboratory, 2022, 68 (02/2022), ⟨10.7754/Clin.Lab.2021.210607⟩. ⟨hal-03864166⟩

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