Effects of hemolysis on the assays of serum CK, CK-MB activities and CK-MB (MASS), troponin and myoglobin measurments

Özcan, Oğuzhan; Karakas, Alparslan; Yücel, Doğan

doi:10.5505/tjb.2012.21043

Cited by 2 publications

(2 citation statements)

References 18 publications

(19 reference statements)

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“…The mechanisms behind the hemolysis interferences include the additive interferences of released intracellular substances (eg, LDH, AST, K, and HBDH) and the chemical interferences when the released substances interacted with the measured analyte (eg, CK and CKMB); it was reported that intracellular adenylate kinase might interfere with the CK assay . In addition, our results showed that positive hemolysis interferences on CK‐MB activity started to increase at lower HI values compared with CK activity, which was in accordance with Oğuzhan Özcan's study . The reason may be that the errors from the interfering agents released by hemolysis were amplified by multiplying a constant; this constant parameter is commonly used to calculate the CKMB activity in the assay.…”

Section: Discussionsupporting

confidence: 90%

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Determination of hemolysis index thresholds for biochemical tests on Siemens Advia 2400 chemistry analyzer

Liu

Zhang

et al. 2019

Clinical Laboratory Analysis

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BackgroundIn vitro hemolysis is still the most common source of pre‐analytical nonconformities. This study aimed to investigate the hemolytic effects on commonly used biochemical tests as well as to determine the hemolysis index (HI) thresholds on Siemens Advia 2400 chemistry analyzer.MethodsPeripheral blood samples were collected from forty healthy volunteers. Hemolysis was achieved using syringes. Five hemolysis levels were produced including the no hemolysis group, slight hemolysis group, mild hemolysis group, moderate hemolysis group, and heavy hemolysis group. We then used the bias from baseline (no hemolysis) and HI to construct regression functions. The HI corresponding to the bias limits was considered as HI thresholds. We chose the total allowable error (TAE) as the bias limit.ResultsOf the twenty‐eight analytes, ten analytes had clinical significance. Creatine kinase‐MB, creatine kinase, potassium, aspartate aminotransferase, and hydroxybutyrate dehydrogenase were all positively affected; the corresponding HI threshold was 45.2, 99.96, 4.07, 10.16, and 7.94, respectively. Lactate dehydrogenase was also positively interfered, but we failed to calculate the HI threshold. Total bile acid, uric acid, and sodium were all negatively affected, and the HI threshold was 42.23, 500 and 501.8, respectively. Glucose was also negatively interfered, but it failed to achieve the HI threshold.ConclusionsWhen the HI value was higher than its threshold, the corresponding analyte was considered inappropriate for reporting. The implementation of the assay‐specific HI thresholds could provide an accurate method to identify analytes interfered by hemolysis, which would improve clinical interpretations and further boost laboratory quality by reducing errors associated with hemolysis.

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Section: Discussionsupporting

confidence: 90%

“…In conclusion, this is the first study to our knowledge that investigated HI thresholds using the Advia 2400 analyzer, which extended these HI studies . Our results provide HI thresholds for eight analytes (CKMB, CK, K, AST, HBDH, TBA, Na, and UA).…”

Section: Discussionsupporting

confidence: 54%

Determination of hemolysis index thresholds for biochemical tests on Siemens Advia 2400 chemistry analyzer

Liu

Zhang

et al. 2019

Clinical Laboratory Analysis

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A Comparative Study on the Diagnostic Utility of Creatine Kinase-MB (Myocardial Band) Mass Estimation Over Its Activity Measurement in Patients with Acute Myocardial Infarction in a Tertiary Care Hospital in Puducherry

Kumar¹,

Rajendran²,

Nanda³

et al. 2021

jebmh

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BACKGROUND Cardiovascular diseases (CVDs) are one of the major health problems and leading cause of death worldwide. Acute myocardial infarction (AMI) is one of the cardiovascular diseases which has high mortality in early hours of presentation and hence early and accurate diagnosis is important to reduce the morbidity and mortality. Troponin I and CKMB (Creatine Kinase-Myocardial Band) activity are the routine biomarkers used for early diagnosis of AMI. Since there is a high degree of instability in the measurement of CKMB activity and also there are frequent noncorrelation with the Troponin I levels, we aimed to estimate and compare the levels of CKMB mass and CKMB activity in patients with and without AMI. METHODS This comparative study included 40 cases and 40 controls. Cases were adult patients between the age group of 30 -70 years diagnosed with AMI by electrocardiogram (ECG) and positive troponin I, and controls were who presented with non myocardial infection (MI) chest pain. Blood samples were collected to estimate CKMB activity and CKMB mass. RESULTS The median value of CKMB activity in controls was 21 IU/L (IQR 13.25-27.75) and that in cases was 40 IU/L (IQR 30.25-94.25) and this difference is statistically significant. The median value of CKMB mass in controls was 5 ngmL (IQ 4-6) and that in cases was 19.50 ng/mL (IQR 6-61.50) which is also statistically significant in differentiating both. In Spearman correlation test, both showed a better statistical significance and correlation in cases (r = 0.787). It was evident that the median value of CKMB activity in controls was higher than that of the normal range for CKMB activity which is 8-16 IU/L, but the median value of CKMB mass in controls was well within the normal range of 5- 10 ng/mL, considering it to be a better marker for eliminating false positive results. CONCLUSIONS CKMB mass can be considered as a better marker than CKMB activity for accurate diagnosis of AMI along with troponin I. KEYWORDS Cardiovascular Diseases, Biomarker, Acute Myocardial Infarction, CKMB Mass, CKMB Activity

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Effects of hemolysis on the assays of serum CK, CK-MB activities and CK-MB (MASS), troponin and myoglobin measurments

Cited by 2 publications

References 18 publications

Determination of hemolysis index thresholds for biochemical tests on Siemens Advia 2400 chemistry analyzer

Determination of hemolysis index thresholds for biochemical tests on Siemens Advia 2400 chemistry analyzer

A Comparative Study on the Diagnostic Utility of Creatine Kinase-MB (Myocardial Band) Mass Estimation Over Its Activity Measurement in Patients with Acute Myocardial Infarction in a Tertiary Care Hospital in Puducherry

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