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1
Department of Clinical Chemistry, Lasarettet, S-251 87 Helsingborg, Sweden.
2
Department of Clinical Chemistry, University Hospital
Lund, 221 85 Lund, Sweden.
3
Department of Clinical Chemistry, Karolinska Sjukhuset,
171 76 Stockholm, Sweden.
4
Department of Clinical Chemistry and Transfusion
Medicine, Ryhov, S-551 85 Jönköping, Sweden.
5
Medizinische Klinik II, Medizinische Universität
zu Lübeck, 23528 Lübeck, Germany.
a Author for correspondence. Fax 46-42-102109; e-mail willie.gerhardt{at}telia.com
Background: Heparinized plasma samples allow more rapid analysis than serum samples, but preliminary studies showed lower cardiac troponin T (cTnT) results in plasma. We undertook a multicenter study to characterize this effect for cTnT and cardiac troponin I (cTnI).
Methods: Blood samples were collected with and without heparin at five hospitals. cTnT was measured by a "third generation" assay (Elecsys®), and cTnI was measured by a commercial immunoassay (IMMULITE®).
Results: Mean cTnT was 15% lower in heparin sampling tubes than in serum. Measured concentrations of cardiac troponins also decreased with increasing heparin concentrations added to sera. Heparin-induced losses were greater in early than in late phases after onset of chest pain. Addition of heparin (~100 IU/mL) to serial samples from nine acute myocardial infarction patients produced mean cTnT losses of 33% at 1–12 h after onset of chest pain, 17% at 13–48 h, and 7% after 48 h. The changing heparin effects were seen for both cTnT and cTnI during time courses of individual patients with myocardial infarction.
Conclusion: We suggest that binding of heparin to troponins decreases immunoreactivity, especially in early phases of myocardial injury. The resulting losses may depend on the antibodies used in each troponin assay.
The following articles in journals at HighWire Press have cited this article:
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  D. C Gaze and P. O Collinson Multiple molecular forms of circulating cardiac troponin: analytical and clinical significance Ann Clin Biochem, July 1, 2008; 45(4): 349 - 355. [Abstract] [Full Text] [PDF]
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P. Venge, B. Lindahl, and L. Wallentin New Generation Cardiac Troponin I Assay for the Access Immunoassay System Clin. Chem., May 1, 2001; 47(5): 959 - 961. [Full Text] [PDF]
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F. S. Apple and A. H.B. Wu Myocardial Infarction Redefined: Role of Cardiac Troponin Testing Clin. Chem., March 1, 2001; 47(3): 377 - 379. [Full Text] [PDF]
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 A. S. Jaffe, J. Ravkilde, R. Roberts, U. Naslund, F. S. Apple, M. Galvani, and H. Katus It's Time for a Change to a Troponin Standard Circulation, September 12, 2000; 102(11): 1216 - 1220. [Full Text] [PDF]
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