Current and Future Indication for Testing and Use of Cardiac Troponin in Children

Current studies report high cTn concentrations in healthy infants and newborns. The nadir is reached at 1-3 years at which time concentrations gradually increase, reaching adult levels through puberty. The incidence of myocardial injury is reported to be low and dependent on whether the 97.5th or 99th percentile is chosen as the upper reference limit. The main clinical indication for testing appears to be suspicion of myo/pericarditis or traumatic chest injury. On occasion, cTn is measured in cases of possible heart failure and/or myocardial ischemia. There is heterogeneity among the limited clinical studies published. Most of the data are retrospective, and the current suggestions for clinical practice are thus largely based on expert opinion. More research is needed regarding all aspects of cTn testing in children, and suggestions for future research are included at the end of this review.

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Publication Details

Journal
Clinical Chemistry
Published
2026-03-27
DOI
https://doi.org/10.1093/clinchem/hvag021
Primary Topic
Acute Myocardial Infarction Research
Type
article
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article

Current and Future Indication for Testing and Use of Cardiac Troponin in Children

Ola Hammarsten, A. S. Jaffe, Louise Cullen, F. S. Apple et al.
Clinical Chemistry
Acute Myocardial Infarction Research
article

Current and Future Indication for Testing and Use of Cardiac Troponin in Children

Ola Hammarsten, A. S. Jaffe, Louise Cullen, F. S. Apple, Fabienne Decrue, Sharon Markham Geaghan, Torbjørn Omland, Yader Sandoval, Brian W McCrindle, Nicholas L Mills, Kristin M Aakre, Paul O Collinson, Aamir Jeewa
article en

Abstract

Current studies report high cTn concentrations in healthy infants and newborns. The nadir is reached at 1-3 years at which time concentrations gradually increase, reaching adult levels through puberty. The incidence of myocardial injury is reported to be low and dependent on whether the 97.5th or 99th percentile is chosen as the upper reference limit. The main clinical indication for testing appears to be suspicion of myo/pericarditis or traumatic chest injury. On occasion, cTn is measured in cases of possible heart failure and/or myocardial ischemia. There is heterogeneity among the limited clinical studies published. Most of the data are retrospective, and the current suggestions for clinical practice are thus largely based on expert opinion. More research is needed regarding all aspects of cTn testing in children, and suggestions for future research are included at the end of this review.

Clinical Chemistry
University of Minnesota (US), Abbott Northwestern Hospital (US), Queensland University of Technology (AU), St George's, University of London (GB), University of Oslo (NO), Royal Brisbane and Women's Hospital (AU), Akershus University Hospital (NO), Hennepin County (US), Haukeland University Hospital (NO), Sahlgrenska University Hospital (SE), Hospital for Sick Children (CA), Hennepin County Medical Center (US), Mayo Clinic in Arizona (US), University Children’s Hospital Basel (CH), Hennepin Healthcare Research Institute (US), University of Bergen (NO), Stanford University (US), University of Edinburgh (GB)
Openalex Percentile: Top 6%
Acute Myocardial Infarction Research
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