Effect of elevated concentration of alkaline phosphatase on cardiac troponin I assays

Dasgupta, Amitava; Chow, Leonard; Wells, Alice; Datta, Pradip

doi:10.1002/jcla.1023

Cited by 31 publications

(28 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Outlier detection is a critical part of determining whether a particular value should be excluded from the final calculation of a reference limit. Sources of outliers might include preanalytical factors, such as inclusion of unhealthy individuals, poor sample handling, and transcription errors, or analytical factors, such as fibrin clots, hemolysis, heterophile antibodies, horse‐anti‐mouse antibodies, and increased ALP . Incomplete clotting of serum samples can lead to nonspecific binding of fibrin with the capture and labeling antibodies or fibrin interference with the assay's enzymatic reaction .…”

Section: Discussionmentioning

confidence: 99%

Cardiac Troponin I in Racing Standardbreds

Slack

Boston

Soma

et al. 2012

Veterinary Internal Medicne

View full text Add to dashboard Cite

Background Upper reference limits for cTnI have not been established for healthy Standardbred racehorses. Objectives To establish cTnI upper reference limits for Standardbred racehorses and determine if increases in plasma cTnI concentration can be detected in 1–2 hours after a race. Animals Samples were obtained from 586 apparently healthy Standardbreds aged 2–14 years before racing and from the winners of 144 races 1–2 hours after the end of the race. Methods Prospective, observational study; convenience sampling; assay validation; and reference limits determinations were performed according to ASCVP guidelines. Plasma cardiac troponin I concentrations before racing were determined, potential outliers identified, and the 95th and 99th percentile upper reference limits calculated using nonparametric methods. The correlation between cTnI concentration and age, differences in median cTnI concentrations by subgroups and differences between cTnI concentrations before and after racing in winning horses were determined. Results The 95th and 99th percentile upper reference limits for all horses excluding outliers were < 0.04ng/mL and 0.06 ng/mL. There were no significant differences in cTnI concentrations based on age (P = .06), sex (P = .35), gait (P = .55), or race classification (P = .65) and a weak correlation of cTnI with age (ρ = 0.09, P = .03). There were no significant differences between cTnI concentrations before and after racing in winning horses (P = .70). Conclusions and Clinical Importance Because of lack of standardization across cTnI assays, the reference limits apply only to the Stratus CS immunoassay. Future studies looking at the effects of high intensity, short duration exercise on cTnI should consider sampling more than 2 hours after racing or using an ultrasensitive assay.

show abstract

Section: Discussionmentioning

confidence: 99%

Cardiac Troponin I in Racing Standardbreds

Slack

Boston

Soma

et al. 2012

Veterinary Internal Medicne

View full text Add to dashboard Cite

show abstract

“…Fleming [20]. The presence of high phosphatase alkaline levels may also interfere with assays [21]. In addition, other factors may interfere with cardiac Troponin I assay results: lipid, auto antibodies, human antimouse antibodies, and heparin [22].…”

Section: Discussionmentioning

confidence: 99%

Should We Consider Bilirubin When Dosing Troponin in Newborns? Case Report

Giacchi¹,

Mattia²,

Betta³

et al. 2015

Int J Clin Case Stud

View full text Add to dashboard Cite

Background: Troponin is a protein of the troponin-tropomyosin complex in myocardium and it is considered an highly sensitive marker of myocardial necrosis both in adults and newborns with perinatal asphyxia. Some studies assume that high troponin levels in adults without signs of myocardial necrosis could be conditioned by some factors, such as hemolysis, turbidity, and hyperbilirubinemia. Case presentation: We report a case of a term female newborn of Caucasian race, with high troponin levels in absence of neonatal asphyxia and without clinical or instrumental signs of myocardial ischaemia. Conclusion: Hyperbilirubinemia might be a factor that could interfere with assessment of sieric troponin T. This might suggest that levels of troponin T should be trusted only when they are associated with signs of other conditions suggesting heart damage or respiratory distress.

show abstract

“…In addition, analytical errors may lead to false positive troponin elevations in the absence of myocyte necrosis. These errors may be related to interference with the troponin assay by fibrin,2 alkaline phosphatase,3 haemolysis4 and instrumentation malfunction.…”

Section: Discussionmentioning

confidence: 99%

False positive cardiac troponin elevation due to heterophile antibodies: more common than we recognise?

Zaidi

Cowell²

2010

Case Reports

View full text Add to dashboard Cite

SummaryA 53-year-old woman was admitted with non-exertional chest pain and elevated cardiac troponin I (cTnI) without dynamic changes of ischaemia on the ECG. She had recently undergone coronary angiography which had shown normal coronary vessels. Repeat angiography on this admission was again unremarkable. Samples of blood were sent for analysis using different troponin assays and demonstrated chronic basal elevation of cTnI while simultaneous assay for troponin T (cTnT) remained normal. Subsequent testing revealed the presence of heterophile antibodies interfering with the troponin I assay leading to a false positive result. BACKGROUND

show abstract

Effect of elevated concentration of alkaline phosphatase on cardiac troponin I assays

Cited by 31 publications

References 18 publications

Cardiac Troponin I in Racing Standardbreds

Cardiac Troponin I in Racing Standardbreds

Should We Consider Bilirubin When Dosing Troponin in Newborns? Case Report

False positive cardiac troponin elevation due to heterophile antibodies: more common than we recognise?

Contact Info

Product

Resources

About