Measurement in different sample types may aid in detecting interferences and macrocomplexes affecting cardiac troponin measurements

Kavsak, Peter A.

doi:10.1515/cclm-2021-1251

Cited by 5 publications

(1 citation statement)

References 20 publications

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“…16 Other specimen types such as EDTA plasma, a potentially important factor, have also not been evaluated in this study. 15,17 In this study, we did not compare every specimen with a molecular weight-based method (e.g. GFC or sucrose gradient method 18 ) due to the impracticalities of testing a large number of samples.…”

Section: Discussionmentioning

confidence: 99%

Practical approaches to the detection of macrotroponin

Lam

Kyle

2023

Ann Clin Biochem

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Introduction: Macrotroponin is increasingly recognised as a cause of confusion in interpreting high-sensitivity cardiac troponin (hs-cTnI) results. In this study, we sought to evaluate two practical approaches to detecting macrotroponin. These two approaches are PEG precipitation and SVM (support vector machine) analysis to classify discrepancies between hs-cTn assays. Method: Residual serum and heparin plasma specimens (n=483) with initially elevated hs-cTnI from hospital and community laboratories were retested on multiple hs-cTn platforms before and after PEG precipitation and Protein A immunoglobulin depletion. SVM analysis was conducted to identify a linear equation that best discriminated specimens with macrotroponin using a combination of results from two different hs-cTn assays. Findings: The diagnostic performance of PEG precipitation was carried out using Protein A immunoglobulin depletion as the reference comparator. When a cutoff residual activity after PEG precipitation of ≤ 20% was used, this threshold carried a high specificity of 92% (confidence interval 83 – 98%; n = 189) using the Siemens hs-cTnI Vista assay and 95% specificity (86% - 98%; n = 242) using the Abbott hs-cTnI Architect assay. SVM analysis generated a linear equation identifying macrotroponin specimens from results obtained on two hs-cTn assays. This approach can be highly specific, comparable to PEG precipitation when certain assay combinations and concentrations are used. Conclusion: We describe and identify practical alternatives to detecting macrotroponin. These approaches can be optimised for high specificity, reducing the need for more complex laboratory methods.

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