Global survey finds pediatric troponin testing often relies on adult benchmarks
An international survey of laboratory specialists and clinicians from 48 countries found that most labs testing children for cardiac troponin use adult reference intervals instead of child-specific ones. Among respondents, 58.5% offered in-house troponin testing, but 65.5% of those lacked pediatric reference intervals, often relying on manufacturer-provided adult ranges. Inconsistent cutoffs and missing validated pediatric guidelines were identified as major barriers to reliable heart care for children.
Cardiac troponin is a blood marker released when heart muscle is injured. In adults, it has transformed heart attack assessment. Pediatric use is harder because normal values for children are not well established. An IFCC committee surveyed laboratory specialists and clinicians across 48 countries, with results published in Clinical Chemistry and Laboratory Medicine.
Among respondents, 58.5% performed troponin testing on site, yet 65.5% of those had no child-specific reference intervals. Many used adult ranges supplied by manufacturers. Clinics that created pediatric benchmarks used differing thresholds, and no consensus existed on deriving them. Children may need tailored cutoffs for conditions such as heart infections, Kawasaki disease, or cancer-treatment-related cardiac damage.
Children undergoing heart evaluations may be affected if adult troponin thresholds do not match children's physiology. Clinicians and laboratories could face uncertainty, potentially prompting extra testing, delayed recognition of injury, or inconsistent care between hospitals and countries. Families may experience anxiety, costs, or referral delays when results are hard to interpret. Better validated pediatric ranges could improve confidence and comparability, though creating and adopting them may demand coordinated resources and training.