10% CV concentration for the fourth generation Roche cardiac troponin T assay derived from Internal Quality Control data

Clinical Laboratory Analysis

Tessitore

et al. 2008

The diagnostic approach to acute coronary syndrome (ACS) is challenging in patients with impaired renal function since most serum biomarkers are commonly increased in this clinical setting. Cardiac troponin T (cTnT), creatine kinase isoenzyme MB (CK MB), myoglobin, and ischemia modified albumin (IMA), were assayed in 45 patients prehemodialysis (pre-HD) and posthemodialysis (post-HD), and results were adjusted for hemoconcentration. The pre-HD values of serum IMA and cTnT were above the respective diagnostic thresholds (IMAo85 K units/L; cTnT o0.03 ng/mL) in six (13%) and 27 (60%) patients undergoing chronic HD, respectively. A significant (105.0 vs. 79.0 K units/L, Po0.0001) and variable (138%; 95% confidence interval [CI], 12-65%) increase of serum IMA was observed post-HD, whereas the other biomarkers significantly decreased (cTnT: 0.029 vs. 0.044 ng/mL, P 5 0.016; CK-MB:2.33 vs.2.50 mg/L, Po 0.0001; myoglobin: 128.1 vs. 148.7 mg/L, Po0.0001). Biomarkers of myocardial injury, especially cTnT and IMA, might be used in HD patients, provided that an appropriate diagnostic interpretation is guarantee, according to individual baseine value, metabolism, and time of sampling. Moreover, IMA might be reliably applied to stratify the long-term risk of these patients, but not for diagnosing an ACS during or immediately post-HD.

Section: Discussionmentioning

confidence: 99%

Section: Laboratory Methodsmentioning

confidence: 99%

Effect of hemodialysis on traditional and innovative cardiac markers

Clinical Laboratory Analysis

Tessitore

et al. 2008

“…cTnT was assessed on a Modular System E (Roche Diagnostics GmbH, Mannheim, Germany). cTnT results were stratified according to the diagnostic threshold (i.e., [0.03 ng/ml), which corresponds to the lowest cTnT concentration associated with a 10% total imprecision in the laboratory assay [24]. All patients underwent a standard 12-lead electrocardiogram, which was interpreted by an experienced cardiologist according to conventional criteria.…”

Section: Methodsmentioning

confidence: 99%

Relationship between 24-h air pollution, emergency department admission and diagnosis of acute coronary syndrome

Franchini

et al. 2009

J Thromb Thrombolysis

Current available evidence suggests that air pollution, especially particulate matter <10 mum in aerodynamic diameter (PM10), has acute and chronic effects on health. We aimed to evaluate the epidemiological association between 24-h PM10 levels and acute coronary syndrome (ACS). We analyzed the number of daily admissions at the emergency unit (ED) of patients with suspected ACS, and the number of daily diagnosis of ACS in the same local ED according to the 24-h PM10, over a nearly 3-month period. 209 out of the 1,688 patients admitted to the ED with a clinical suspicion of ACS had a definitive diagnosis of ACS. Whereas the mean number of ED admissions for suspected ACS did not differ significantly according to the 24-h levels of PM10 (18 +/- 1 vs. 17 +/- 1; P = 0.13), the mean number of diagnoses of ACS was 26% higher when the 24-h levels of PM10 were >50 microg/m(3) (2.4 +/- 0.2 vs. 1.9 +/- 0.2; P = 0.03). A statistically significant association was also observed between 24-h PM10 levels and daily number of ACS diagnoses (r = 0.26; P < 0.001), but not between 24-h PM10 levels and daily ED accesses for suspected ACS (r = 0.12; P = 0.24). Taken together, these results support the existence of an epidemiologic association between air pollution and acute cardiovascular events.

“…cTnT was assayed on the Elecsys 2010 (Roche Diagnostics GmbH, Mannheim, Germany). Test results were stratified according to the decisional threshold corresponding to the lowest TnT concentration associated with a 10% total imprecision in the assay (>0.03 lg/l) [7]. The samples were centrifuged at 1,500g for 20 min at room temperature and immediately analyzed.…”

Section: Methodsmentioning

confidence: 99%

Diagnostic value of D-dimer measurement in patients referred to the emergency department with suspected myocardial ischemia

Filippozzi

et al. 2007

J Thromb Thrombolysis

Results of the present investigation on patients with AMI established by accepted diagnostic criteria (cTnT values above the decisional threshold of the assay associated with suggestive clinical symptoms), testify that D-dimer testing would not add clinically meaningful information to the sole determination of the cardiospecific troponins 12-24 h after patient's admission at the emergency department, when the cumulative data indicate that the diagnostic efficiency of cTnT is the highest.