Serum and plasma as alternative sample types in analysis of cardiac markers in the clinical routine

Abstract

There is an increasing demand for the results of cardiac markers (troponin I or T, creatine kinase MB mass and myoglobin) to be made available promptly after sample-taking. In order to shorten the turnaround time, the possibility of using EDTA- or heparin-plasma instead of serum was investigated. The study population comprised 391 patients with acute chest pain. Four different instruments and systems routinely used in Finland giving quantitative results were studied for the assays of creatine kinase isoenzyme MB mass, myoglobin, and troponin I or troponin T. In addition to serum samples, heparin-plasma seems to be useful for all three assays using the Access and Immulite systems, while EDTA-plasma seems to be useful for all three assays with the Access and Elecsys systems. For the AxSYM assays, serum samples seem to be the best alternative. In conclusion, it is possible to use a single EDTA- or heparin-plasma sample for Access, Elecsys and Immulite analysers, and thereby to shorten the turnaround time. In this way the quantitative analyses from plasma can be performed 30 min after taking the sample.

Imprecision of cardiac marker analyses among laboratories on the basis of external quality assurance results: Finnish experience

“…CK activity of the serum and plasma samples was measured photometrically using the IFCC method [7,8] Table I. The methods used by the laboratories participating in the surveys during the study period are presented in Table II.…”

“…The ElecsysH 2010 electrochemiluminescent system (Roche Diagnostics, Mannheim, Germany) was used for measuring CK-MBmass (CK-MB STAT) and cTnT (Troponin T STAT) [8]. For cTnI, two assays, the AxSYMH microparticle enzyme immunoassay for cTnI (AxSYMH Troponin-I, Abbott Diagnostics Inc., Abbott Park, Ill., USA) [9] and the ImmuliteH 2000 two-site chemiluminescent immunoassay for cTnI (ImmuliteH 2000 Troponin I, Diagnostic Products Co., Los Angeles, Calif., USA), which were both available in our laboratory, were used in accordance with the instructions of the manufacturers.…”

Plasma or serum samples: measurements of cardiac troponin T and of other analytes compared

“…Accordingly, it was suggested to Brought to you by | University of Georgia Libraries Authenticated Download Date | 6/12/15 3:00 AM adhere to the NACB recommendations to use plasma as the preferred sample for stat analysis, and to calibrate with plasma-based calibrators when this type of sample is used. However, a single EDTA-or heparin-plasma proved suitable for three of the four analyzers, thereby permitting significant shortening of the turnaround time (13). In a further study (12), comparing plasma/serum pairs and studying of the effect of heparin addition to serum, it was concluded that the mean plasma/serum ratio was close to 1, but the plasma/serum variability was large, in one out of a hundred samples leading to an underestimation in plasma up to 46%.…”

CK-MB Aktivite ve Kütle Ölçüm Yöntemlerinin Karşılaştırılması

“…Kardiyak belirteçlerin (troponin I veya T, CK-MB ve miyoglobin) numune alımından hemen sonra erken zamanda sonuç alınmasına yönelik klinesyenler tarafından artan bir talep vardır. Geri dönüş süresini (TAT) kısaltmak için serum yerine EDTA-veya heparinplazma kullanılmaktadır (11). AMI tanısında, daha erken sonuç almak için birçok laboratuvar serum yerine plazmayı tercih etmektedir (12).…”