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1
Institut für Klinische Chemie und Pathobiochemie,
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Medizinische Klinik I, and
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Klinik für Thorax-, Herz- und Gefässchirurgie, Universitätsklinikum der RWTH Aachen, 52074 Aachen, Germany.
a Address correspondence to this author at: Institut für Klinische Chemie und Pathobiochemie, Universitätsklinikum der RWTH Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany. Fax 49-0-241-8888-512; e-mail hugo.stiegler{at}post.rwth-aachen.de
Background: The use of plasma rather than serum for determination of cardiac troponins can improve turnaround time and potentially avoid incomplete serum separation that may produce falsely increased results. We investigated the influence of incomplete serum separation and the effect of heparin-plasma on cardiac troponin concentrations.
Methods: Serum and heparin-plasma samples were drawn simultaneously from 100 patients (50 patients with acute coronary syndrome and 50 patients after open heart surgery) and measured on three different analytical systems, two for determination of cardiac troponin I (cTnI; Abbott AxSYM and Bayer ACS:Centaur) and one for cardiac troponin T (cTnT; Roche Elecsys cTnT STAT). Serum samples were reanalyzed after a second centrifugation to assess the influence of incomplete serum separation.
Results: Mean results (± 95% confidence interval) in heparin-plasma compared with serum were 101% ± 2% (AxSYM cTnI), 94% ± 3% (ACS:Centaur cTnI), and 99% ± 3% (Elecsys cTnT). Differences >20% were seen in 11% of results on the ACS:Centaur, 9% of results on Elecsys cTnT, and 2% of results on the AxSYM. For the Elecsys cTnT assay, the magnitude of the difference between serum and plasma was independent of the absolute concentration and confined to individual samples, and was reversed by treatment with heparinase. A second centrifugation had no effect on serum results by any of the assays.
Conclusion: The concentrations of troponins measured in heparin-plasma are markedly lower than in serum in some cases.
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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D. Peetz, G. Hafner, and K. J. Lackner Analytical Characteristics of the AxSYM Cardiac Troponin I and Creatine Kinase MB Assays Clin. Chem., July 1, 2002; 48(7): 1110 - 1111. [Full Text] [PDF]
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M. Groschl, R. Wagner, J. Dotsch, W. Rascher, and M. Rauh Preanalytical Influences on the Measurement of Ghrelin Clin. Chem., July 1, 2002; 48(7): 1114 - 1116. [Full Text] [PDF]
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A. Cerutti, L. Corsini, R. Finotto, and C. Perazzi Comparison of Cardiac Troponin I in Serum and Heparin Plasma with the Dimension RxL Assay Clin. Chem., May 1, 2002; 48(5): 790 - 791. [Full Text] [PDF]
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G. P. Armstrong, A. N. Barker, H. Patel, and H. H. Hart Reference Interval for Troponin I on the ACS:Centaur Assay: A Recommendation Based on the Recent Redefinition of Myocardial Infarction Clin. Chem., January 1, 2002; 48(1): 198 - 199. [Full Text] [PDF]
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 M. J. Quinn and D. J. Moliterno Troponins in Acute Coronary Syndromes: More TACTICS for an Early Invasive Strategy JAMA, November 21, 2001; 286(19): 2461 - 2462. [Full Text] [PDF]
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G. H. White and P. A. Tideman Increased Troponin T in a Patient with Dermatomyositis Clin. Chem., June 1, 2001; 47(6): 1130 - 1131. [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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K. F. Buechler, K. K. Nakamura, W. Gerhardt, G. Nordin, A. Isaksson, S. Haglund, E. Gustavsson, M. Muller-Bardorf, and H. A. Katus Diagnostic accuracy of an agarose gel electrophoretic method in multiple sclerosis. Clin. Chem., January 1, 2001; 47(1): 144 - 144. [Full Text] [PDF]
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