Effect of Hemolysis on Plasma Cardiac Troponin Levels at Clinically Relevant Concentrations: An Experimental Study

Al-Shidhani, Maya; Saadi, Huda Al; Mula-Abed, Waad Allah; Riyami, Nafila B. Al

doi:10.4172/0974-8369.1000217

Cited by 3 publications

(2 citation statements)

References 10 publications

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“…These results indicated that the developed dip strip immunoassay retained its specificity toward cTnI determination despite presence of albumin, bilirubin and cholesterol. For interfering substance, hemoglobin may cause interference if the hemolyzed serum was presented 37 , 38 . The results of cardiac troponin I concentration should therefore be interpreted with caution for mildly hemolyzed serum with the slightly detectable pink color, while the moderately or severely hemolyzed serum should be rejected.…”

Section: Resultsmentioning

confidence: 99%

Silver-enhanced colloidal gold dip strip immunoassay integrated with smartphone-based colorimetry for sensitive detection of cardiac marker troponin I

Poosinuntakul

Chanmee

Porntadavity

et al. 2022

Sci Rep

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Cardiac troponin I (cTnI) is a specific cardiac biomarker for diagnosis of acute myocardial infarction (AMI). A sensitive and simple point-of-care test (POCT) is still required for early detection of AMI. To address this need, we developed a dip strip assay based on sandwich immunoassay coupled with a silver enhancement system. Pre-incubation and silver enhancement were introduced to the dip strip to increase sensitivity. Due to the catalytic reaction of the silver enhancement solution, the red color of AuNPs changed to dark brown as silver ions precipitated and enlarged the AuNPs. The obtained results were easily seen by the naked eye. For quantitative analysis, the color intensity of the results was analyzed using a smartphone with RGB color picker application. The effects of operating parameters (volume of AuNP-Ab conjugate, volume of sample, incubation time, and analysis time) were investigated and optimized. Under optimal conditions, the limit of detection (LOD) by the naked eye was 0.5 ng/mL. The LOD with silver enhancement was 50-fold lower than without. For quantitative analysis using the smartphone, linearity of detection was observed through the range of 0.5–50 ng/mL (R2 = 0.9952) and the LOD was 0.12 ng/mL. The developed method was successfully applied to detection of cTnI in serum samples, achieving analytical recoveries and %RSD in the ranges of 96.10–119.17% and 2.91–5.13%, respectively. Additionally, this developed assay was not cross reactive with the potentially interfering serum proteins. These results showed the great potential of this dip strip assay as an alternative POCT for detection of serum cTnI.

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Section: Resultsmentioning

confidence: 99%

Silver-enhanced colloidal gold dip strip immunoassay integrated with smartphone-based colorimetry for sensitive detection of cardiac marker troponin I

Poosinuntakul

Chanmee

Porntadavity

et al. 2022

Sci Rep

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“…The analytes most affected by hemolysis due to the loss of red blood cell content in plasma are potassium, LDH, and AST. Some authors also describe the interference of hemolysis in troponin analysis [ 17 ].Potassium is the most relevant indicator that an incorrect dosage of this electrolyte could have for clinical implications [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Is There a Risk of Misinterpretation of Potassium Concentration from Undetectable Hemolysis Using a POCT Blood Gas Analyzer in the Emergency Department?

et al. 2022

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Background and Objectives: Hemolysis is reported to be present in up to 10% of blood gas specimens in the central lab; however, few data on the incidence of hemolysis using a point-of-care testing (POCT) blood gas analysis are available in the setting of the emergency department. The aims of this study were: (1) to analyze the prevalence of hemolysis in blood gas samples collected in the ED using a POCT device; and (2) to evaluate the impact of hemolysis on blood sample results and its clinical consequences. Materials and Methods: We collected 525 consecutive POCT arterial blood gas samples using syringes with electrolyte-balanced heparin within 3 different EDs in the metropolitan area of Rome. Immediately after the collection, the blood samples were checked for the presence of hemolysis with a POCT instrument (i.e., HEMCHECK, H-10 ®). The samples were then subsequently processed for blood gasses, and an electrolytes analysis by a second operator blinded for the hemolysis results. A venous blood sample was simultaneously collected, analyzed for it’s potassium value, and used as a reference. Results: Of the samples, 472 were considered for the statistics, while 53 were excluded due to the high percentage of hemolysis due to operator fault in carrying out the measurement. The final mean hemolysis per operator was 12% (±13% SD), and the total final hemolysis was 14.4%.Potassium (K+) was significantly higher in the hemolyzed group compared with the non-hemolyzed sample (4.60 ± 0.11 vs. 3.99 ± 0.03 mEq/L; p < 0.001), and there were differences between arterial potassium versus venous potassium (D(a-v) K+, 0.29 ± 0.06 vs.−0.19 ± 0.02 mEq/L, p < 0.01). A Bland–Altman analysis confirmed that hemolysis significantly overestimated blood potassium level. Conclusion: Almost 12% of POCT blood gas analysis samples performed in the ED could be hemolyzed, and the presence of this hemolysis is not routinely detected. This could cause an error in the interpretation of the results, leading to the consideration of potassium concentrations being below the lower limit within the normal limits and also leading to the diagnosis of false hyperkalemia, which would have potential clinical consequences in therapeutic decision-making in the ED. The routine use of a POCT hemolysis detector could help prevent any misdiagnoses.

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Changes in Serum Cardiac Troponin I in Asian Elephants (Elephas Maximus) With Elephant Endotheliotropic Herpesvirus Infection

Anderson¹,

Steeil²,

Latimer³

et al. 2022

Journal of Zoo and Wildlife Medicine

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Effect of Hemolysis on Plasma Cardiac Troponin Levels at Clinically Relevant Concentrations: An Experimental Study

Cited by 3 publications

References 10 publications

Silver-enhanced colloidal gold dip strip immunoassay integrated with smartphone-based colorimetry for sensitive detection of cardiac marker troponin I

Silver-enhanced colloidal gold dip strip immunoassay integrated with smartphone-based colorimetry for sensitive detection of cardiac marker troponin I

Is There a Risk of Misinterpretation of Potassium Concentration from Undetectable Hemolysis Using a POCT Blood Gas Analyzer in the Emergency Department?

Changes in Serum Cardiac Troponin I in Asian Elephants (Elephas Maximus) With Elephant Endotheliotropic Herpesvirus Infection

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