Imprecision of high-sensitivity cardiac troponin assays at the female 99th-percentile.

Female 99th percentile High-sensitivity cardiac troponin Imprecision Upper reference limit

Journal

Clinical biochemistry
ISSN: 1873-2933
Titre abrégé: Clin Biochem
Pays: United States
ID NLM: 0133660

Informations de publication

Date de publication:
13 Feb 2024
Historique:
received: 07 12 2023
revised: 02 02 2024
accepted: 08 02 2024
medline: 16 2 2024
pubmed: 16 2 2024
entrez: 15 2 2024
Statut: aheadofprint

Résumé

An analytical benchmark for high-sensitivity cardiac troponin (hs-cTn) assays is to achieve a coefficient of variation (CV) of ≤ 10.0 % at the 99th percentile upper reference limit (URL) used for the diagnosis of myocardial infarction. Few prospective multicenter studies have evaluated assay imprecision and none have determined precision at the female URL which is lower than the male URL for all cardiac troponin assays. Human serum and plasma matrix samples were constructed to yield hs-cTn concentrations near the female URLs for the Abbott, Beckman, Roche, and Siemens hs-cTn assays. These materials were sent (on dry ice) to 35 Canadian hospital laboratories (n = 64 instruments evaluated) participating in a larger clinical trial, with instructions for storage, handling, and monthly testing over one year. The mean concentration, standard deviation, and CV for each instrument type and an overall pooled CV for each manufacturer were calculated. The CVs for all individual instruments and overall were ≤ 10.0 % for two manufacturers (Abbott CV The number of instruments achieving a CV ≤ 10.0 % at the female 99th-percentile URL varies by manufacturer and by instrument. Monitoring assay precision at the female URL is necessary for some assays to ensure optimal use of this threshold in clinical practice.

Sections du résumé

BACKGROUND BACKGROUND
An analytical benchmark for high-sensitivity cardiac troponin (hs-cTn) assays is to achieve a coefficient of variation (CV) of ≤ 10.0 % at the 99th percentile upper reference limit (URL) used for the diagnosis of myocardial infarction. Few prospective multicenter studies have evaluated assay imprecision and none have determined precision at the female URL which is lower than the male URL for all cardiac troponin assays.
METHODS METHODS
Human serum and plasma matrix samples were constructed to yield hs-cTn concentrations near the female URLs for the Abbott, Beckman, Roche, and Siemens hs-cTn assays. These materials were sent (on dry ice) to 35 Canadian hospital laboratories (n = 64 instruments evaluated) participating in a larger clinical trial, with instructions for storage, handling, and monthly testing over one year. The mean concentration, standard deviation, and CV for each instrument type and an overall pooled CV for each manufacturer were calculated.
RESULTS RESULTS
The CVs for all individual instruments and overall were ≤ 10.0 % for two manufacturers (Abbott CV
CONCLUSIONS CONCLUSIONS
The number of instruments achieving a CV ≤ 10.0 % at the female 99th-percentile URL varies by manufacturer and by instrument. Monitoring assay precision at the female URL is necessary for some assays to ensure optimal use of this threshold in clinical practice.

Identifiants

pubmed: 38360198
pii: S0009-9120(24)00025-0
doi: 10.1016/j.clinbiochem.2024.110731
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

110731

Informations de copyright

Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Auteurs

Peter A Kavsak (PA)

McMaster University, Hamilton, ON, Canada. Electronic address: kavsakp@mcmaster.ca.

Lorna Clark (L)

McMaster University, Hamilton, ON, Canada.

Saranya Arnoldo (S)

University of Toronto, Toronto, ON, Canada.

Amy Lou (A)

Dalhousie University, Halifax, NS, Canada.

Jennifer L Shea (JL)

Saint John Regional Hospital, Saint John, NB, Canada.

Shaun Eintracht (S)

McGill University, Montréal, QC, Canada.

Andrew W Lyon (AW)

University of Saskatchewan, Saskatoon, SK, Canada.

Vipin Bhayana (V)

Western University, London, ON, Canada.

Laurel Thorlacius (L)

University of Manitoba, Winnipeg, MB, Canada.

Joshua E Raizman (JE)

University of Alberta, Edmonton, AB, Canada.

Albert Tsui (A)

University of Alberta, Edmonton, AB, Canada.

Rose Djiana (R)

McGill University, Montréal, QC, Canada.

Michael Chen (M)

University of British Columbia, Vancouver, BC, Canada.

Yun Huang (Y)

Queen's University, Kingston, ON, Canada.

Ali Haider (A)

Queen's University, Kingston, ON, Canada.

Ronald A Booth (RA)

University of Ottawa, Ottawa, ON, Canada.

Chris McCudden (C)

University of Ottawa, Ottawa, ON, Canada.

Paul M Yip (PM)

University of Toronto, Toronto, ON, Canada.

Daniel Beriault (D)

University of Toronto, Toronto, ON, Canada.

David Blank (D)

McGill University, Montréal, QC, Canada.

Angela W S Fung (AWS)

University of British Columbia, Vancouver, BC, Canada.

Jennifer Taher (J)

University of Toronto, Toronto, ON, Canada.

Julie St-Cyr (J)

McGill University, Montréal, QC, Canada.

Sameer Sharif (S)

McMaster University, Hamilton, ON, Canada.

Emilie Belley-Cote (E)

McMaster University, Hamilton, ON, Canada.

Beth L Abramson (BL)

University of Toronto, Toronto, ON, Canada.

Steven M Friedman (SM)

University of Toronto, Toronto, ON, Canada.

Jafna L Cox (JL)

Dalhousie University, Halifax, NS, Canada.

Marco L A Sivilotti (MLA)

Queen's University, Kingston, ON, Canada.

Annabel Chen-Tournoux (A)

McGill University, Montréal, QC, Canada.

Jesse McLaren (J)

University of Toronto, Toronto, ON, Canada.

Susanna Mak (S)

University of Toronto, Toronto, ON, Canada.

Venkatesh Thiruganasambandamoorthy (V)

University of Ottawa, Ottawa, ON, Canada.

Frank Scheuermeyer (F)

University of British Columbia, Vancouver, BC, Canada.

Karin H Humphries (KH)

University of British Columbia, Vancouver, BC, Canada.

Andrew Worster (A)

McMaster University, Hamilton, ON, Canada.

Dennis Ko (D)

University of Toronto, Toronto, ON, Canada.

Kristin M Aakre (KM)

Institute of Clinical Science, University of Bergen, Bergen, Norway; Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway.

Nicholas L Mills (NL)

BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, United Kingdom.

Allan S Jaffe (AS)

Mayo Clinic and Medical Center, Rochester, MN, United States.

Classifications MeSH