Biological and Analytical Variability of a Novel High-Sensitivity Cardiac Troponin T Assay

Vasile, Vlad C.; Saenger, Amy K.; Kroning, Jean M.; Jaffe, Allan S.

doi:10.1373/clinchem.2009.140616

Cited by 135 publications

(95 citation statements)

References 25 publications

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“…This difference in results may have occurred because Frankenstein et al used a younger, healthy population in which small absolute changes lead to relatively large changes in terms of percentage. Vasile and coworkers (12 ) found markedly higher changes than those observed by us and other investigators a RCV values obtained with the log-normal approach are given as the upward and the downward change value and the mean between these values (in parentheses). (11,13 ), most likely for reasons discussed by Frankenstein et al (13 ).…”

Section: Critical Changes In Cardiac Troponinmentioning

confidence: 71%

“…Recently reported studies have addressed variability of cardiac troponin as measured with highsensitivity assays (11)(12)(13). In these investigations small numbers of healthy volunteers were used to establish reference change values (RCVs) and the index of individuality (II) (the intraindividual variation in relation to the interindividual variation) (11 ) of cardiac troponin over hours and weeks.…”

Section: Myocardial Infarction (Mi)mentioning

confidence: 99%

See 1 more Smart Citation

Variation of Cardiac Troponin I and T Measured with Sensitive Assays in Emergency Department Patients with Noncardiac Chest Pain

Scharnhorst¹,

Krasznai

Veer

et al. 2012

Clinical Chemistry

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BACKGROUND: New-generation high-sensitivity assays for cardiac troponin have lower detection limits and less imprecision than earlier assays. Reference 99th-percentile cutoff values for these new assays are also lower, leading to higher frequencies of positive test results. When cardiac troponin concentrations are minimally increased, serial testing allows discrimination of myocardial infarction from other causes of increased cardiac troponin. We assessed various measures of short-term variation, including absolute concentration changes, reference change values (RCVs), and indices of individuality (II) for 2 cardiac troponin assays in emergency department (ED) patients.

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Section: Critical Changes In Cardiac Troponinmentioning

confidence: 71%

Section: Myocardial Infarction (Mi)mentioning

confidence: 99%

Variation of Cardiac Troponin I and T Measured with Sensitive Assays in Emergency Department Patients with Noncardiac Chest Pain

Scharnhorst¹,

Krasznai

Veer

et al. 2012

Clinical Chemistry

View full text Add to dashboard Cite

show abstract

“…Another important, measurable parameter is the inter-individual variation, which reflects biological variations among healthy individuals from a defined population. A number of investigators measured intraand inter-individual variations using various cTn assays [15,[55][56][57][58][59][60]. The results ranged from 4% to 30% for intraindividual variations and from 30% to 200% for interindividual variations as summarized by Nordenskjöld and coworkers [60].…”

Section: What Constitutes the Rise And/or Fall In Ctn Concentrations?mentioning

confidence: 99%

High sensitivity cardiac troponin assays in the clinical laboratories

Jarolím

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

121

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Abstract:Immunoassays measuring cardiac troponins I or T have become firmly established as critical tools for diagnosing acute myocardial infarction. While most contemporary assays provide adequate diagnostic performance, the increased sensitivity and precision of the new, high sensitivity assays that have already been introduced into clinical practice, provide the potential to further shorten intervals between blood draws or the time needed to detect the first significant troponin elevation. In addition to the relatively modest benefits at the diagnostic end, the high sensitivity assays and the investigational ultrasensitive cardiac troponin assays offer improvements for predicting major adverse cardiovascular events, development of heart failure or transition to end-stage kidney disease. These novel high sensitivity assays can measure troponin concentrations in 50%-100% of healthy individuals and therefore allow for the distribution of troponin values within a healthy cohort to be measured, patient's baseline troponin levels to be monitored, and clinicians to be alerted of deteriorating cardiorenal conditions. We envisage that the high sensitivity assays will become important tools for predicting each patient's risk of future adverse events and for guiding and monitoring corresponding adjustments of preventative therapeutic interventions.

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“…Otherwise, the cTn pattern was considered "atypical". For the definition of these δ percentages (estimated as reference change value), we refer to the short-term biological variation for cTn I [36] because, unfortunately, published studies that tried to assess biological variability of cTn T were implausible, as the majority [37] or a significant number [38] of cTn T results in selected individuals were lower than the LoD. One should be aware, however, that cTn I and cTn T may have different biological kinetics in blood, so their biological variation might be different.…”

Section: : Increasing Ctn Positivity Ratesmentioning

confidence: 99%

Laboratory medicine as the science that underpins medicine: the “high-sensitivity” troponin paradigm

Ferraro¹,

Panteghini

2015

Clinical Chemistry and Laboratory Medicine (CCLM)

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Abstract:The availability of so-called high-sensitivity troponin assays (hsTn) has scored a compelling goal for laboratory medicine, allowing the safe clinical application of international recommendations for the definition of acute myocardial infarction (AMI). However, the introduction of hsTn has not been welcomed by clinicians, claiming an increase in false-positive results. Here we critically trace back the steps following the introduction of hsTn by referring to the 5-year practical experience in our academic hospital and to suitable information available in the literature. In agreement with published data, we found that hsTn introduction was associated with an increased number of AMI diagnoses, whereas the test volume, the revascularization rate, and the proportion of cases with negative angiography findings remained virtually unchanged. Fast-track protocols for ruling out AMI have been further optimized to recommend sampling at presentation and after 3 h only. We focus on a cost-effective use of hsTn that can account for all clinical variables increasing the pre-test probability in order to ensure that tests are ordered only for patients at medium to high risk for acute coronary syndrome (ACS). To guide interpretation of results, hsTn typical release patterns suggestive for AMI should be identified by evaluating the significance of concentration changes. hsTn have markedly shortened the time to rule out or rule in AMI and has the potential to improve the prognostic assessment of critical patients in clinical contexts different from ACS.

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Biological and Analytical Variability of a Novel High-Sensitivity Cardiac Troponin T Assay

Cited by 135 publications

References 25 publications

Variation of Cardiac Troponin I and T Measured with Sensitive Assays in Emergency Department Patients with Noncardiac Chest Pain

Variation of Cardiac Troponin I and T Measured with Sensitive Assays in Emergency Department Patients with Noncardiac Chest Pain

High sensitivity cardiac troponin assays in the clinical laboratories

Laboratory medicine as the science that underpins medicine: the “high-sensitivity” troponin paradigm

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