Differences in measurement of high-sensitivity troponin in an on-demand and batch-wise setting. Issue 3 (23rd July 2020)

• Record Type: Journal Article
• Authors: Sörensen, Nils Arne; Neumann, Johannes Tobias; Ojeda, Francisco; Renné, Thomas; Karakas, Mahir; Blankenberg, Stefan; Westermann, Dirk; Zeller, Tanja
• Is Part Of: European heart journal. Volume 10:Issue 3(2021)
• Page Start: 302
• Page End: 309
• Publication Date: 2020-07-23
• Subjects: Troponin I -- troponin T -- batch -- on-demand -- clinical routine -- high-sensitivity -- myocardial infarction; 616.1205
• DOI: 10.1177/2048872620924198
• Languages: English
• ISSNs: 2048-8726

Abstract

Abstract: Background: Most studies assessing the diagnostic value of high-sensitivity troponin in the diagnosis of myocardial infarction used batch-wise analyses of frozen samples for high-sensitivity troponin measurements. Whether the accuracy of these batch-wise high-sensitivity troponin measurements described in diagnostic studies is comparable to clinical routine is unknown. Methods: We enrolled 937 patients presenting with suspected myocardial infarction in this prospective cohort study. Measurements of high-sensitivity troponin I (Abbott Architect) and high-sensitivity troponin T (Roche) were performed in two settings: (a) on-demand in clinical routine using fresh blood samples; and (b) in batches using frozen blood samples from the same individuals at three timepoints (0 hours, 1 hour and 3 hours after presentation). Results: Median troponin levels were not different between on-demand and batch-wise measurements. Troponin levels in the range of 0 to 40 ng/L showed a very high correlation between the on-demand and batch setting (Pearson correlation coefficient ( r ) was 0.92–0.95 for high-sensitivity troponin I and 0.96 for high-sensitivity troponin T). However, at very low troponin levels (0 to 10 ng/L) correlation between the two settings was moderate ( r for high-sensitivity troponin I 0.59–0.66 and 0.65–0.69 for high-sensitivity troponin T). Application of guideline-recommended rapid diagnostic algorithms showed similar diagnostic performance with both methods. Conclusions: Overall on-demand and batch-wise measurements of high-sensitivity troponin provided similar results, but their correlation was moderate, when focusing on very low troponin levels. The application of rapid diagnostic algorithms was safe in both settings. Trial Registration: www.clinicaltrials.gov (NCT02355457)