Troponin elevation in supraventricular tachycardia: A narrative review

Table 1 Assay-specific 99^th percentile cut-offs, delta thresholds, and universal definition of myocardial infarction classification criteria for high-sensitivity cardiac troponin

Category	Details
Universal definition of myocardial infarction categories	Acute myocardial injury: Hs-cTn ≥ 99th percentile + significant rise/fall. Chronic myocardial injury: Persistent elevation without dynamic change. Type 1 MI: Acute injury + ischemia evidence due to coronary thrombosis/plaque rupture. Type 2 MI: Acute injury + imbalance in supply-demand (e.g., tachyarrhythmia, hypotension) with supportive clinical/electrocardiogram/echo evidence
99th percentile cut-offs (assay-specific examples)1	Roche hs-cTnT (gen 5): 14 ng/L (general); some United States reports: 14 ng/L women, 22 ng/L men. Abbott hs-cTnI: 17 ng/L (women), 35 ng/L (men). Siemens hs-cTnI: Approximately 18 ng/L (women), approximately 27 ng/L (men)
Delta thresholds (European Society of Cardiology 0/1 hour and 0/2 hours algorithms; assay-specific)1	Roche hs-cTnT 0/1 hour: Rule-out: < 5 ng/L or < 12 ng/L with Δ < 3 ng/L; rule-in: ≥ 52 ng/L or Δ ≥ 5 ng/L. Roche hs-cTnT 0/2 hours: Rule-out: Δ ≤ 3 ng/L below 99th percentile; rule-in: Δ ≥ 10 ng/L. Abbott hs-cTnI 0/1 hour (examples): Rule-out: Baseline < 4 ng/L + Δ < 2 ng/L; rule-in: ≥ approximately 64 ng/L or Δ ≥ approximately 6 ng/L. Abbott hs-cTnI 0/2 hours: Rule-out Δ < 2 ng/L; rule-in Δ ≥ 15 ng/L

¹Values are derived from the 2023 European Society of Cardiology Guidelines for the management of acute coronary syndromes and corresponding assay manufacturer data. Thresholds are assay-specific and may vary by platform; institutions should apply values validated for their own laboratory.

Thresholds and algorithms are assay-specific; institutions should apply values validated for their laboratory platform. European Society of Cardiology 2023 guidelines endorse 0/1 hour and 0/2 hours strategies as class I recommendations. hs-cTn: High-sensitivity cardiac troponin; MI: Myocardial infarction.