{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T10:39:04Z","timestamp":1792147144402,"version":"4.4.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T00:00:00Z","timestamp":1655510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,27]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>The International Federation of Clinical Chemistry Committee on Clinical Application of Cardiac Bio-Markers provides evidence-based educational documents to facilitate uniform interpretation and utilization of cardiac biomarkers in clinical laboratories and practice. The committee\u2019s goals are to improve the understanding of certain key analytical and clinical aspects of cardiac biomarkers and how these may interplay in clinical practice. Measurement of high-sensitivity cardiac troponin (hs-cTn) assays is a cornerstone in the clinical evaluation of patients with symptoms and\/or signs of acute cardiac ischemia. To define myocardial infarction, the Universal Definition of Myocardial Infarction requires patients who manifest with features suggestive of acute myocardial ischemia to have at least one cTn concentration above the sex-specific 99th percentile upper reference limit (URL) for hs-cTn assays and a dynamic pattern of cTn concentrations to fulfill the diagnostic criteria for MI. This special report provides an overview of how hs-cTn 99th percentile URLs should be established, including recommendations about prescreening and the number of individuals required in the reference cohort, how statistical analysis should be conducted, optimal preanalytical and analytical protocols, and analytical\/biological interferences or confounds that can affect accurate determination of the 99th percentile URLs. This document also provides guidance and solutions to many of the issues posed.<\/jats:p>","DOI":"10.1093\/clinchem\/hvac092","type":"journal-article","created":{"date-parts":[[2022,6,18]],"date-time":"2022-06-18T10:50:24Z","timestamp":1655549424000},"page":"1022-1030","source":"Crossref","is-referenced-by-count":95,"title":["Analytical Considerations in Deriving 99th Percentile Upper Reference Limits for High-Sensitivity Cardiac Troponin Assays: Educational Recommendations from the IFCC Committee on Clinical Application of Cardiac Bio-Markers"],"prefix":"10.1093","volume":"68","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7340-6736","authenticated-orcid":false,"given":"Kristin M","family":"Aakre","sequence":"first","affiliation":[{"name":"Department of Medical Biochemistry and Pharmacology and Department of Heart Disease, Haukeland University Hospital , Bergen , Norway"},{"name":"Department of Clinical Science, University of Bergen , Bergen , Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy K","family":"Saenger","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine and Pathology, Hennepin Healthcare\/HCMC, Minneapolis, MN , USA"},{"name":"Department of Laboratory Medicine and Pathology, University of Minnesota , Minneapolis, MN , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9089-8130","authenticated-orcid":false,"given":"Rick","family":"Body","sequence":"additional","affiliation":[{"name":"Emergency Department, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre , Manchester , UK"},{"name":"Division of Cardiovascular Sciences, The University of Manchester , Manchester , UK"},{"name":"Healthcare Sciences Department, Manchester Metropolitan University , Manchester , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7000-5996","authenticated-orcid":false,"given":"Paul","family":"Collinson","sequence":"additional","affiliation":[{"name":"Department of Clinical Blood Sciences and Cardiology, St George\u2019s University Hospitals NHS Foundation Trust , London , UK"},{"name":"Departments of Clinical Blood Sciences and Cardiology, St George\u2019s University of London , London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola","family":"Hammarsten","sequence":"additional","affiliation":[{"name":"Department of Clinical Chemistry and Transfusion Medicine, University of Gothenburg , Gothenburg , Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan S","family":"Jaffe","sequence":"additional","affiliation":[{"name":"Departments of Laboratory Medicine and Pathology and Cardiology, Mayo Clinic , Rochester, MN , 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