Clinical Chemistry Email Content Delivery
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Clinical Chemistry 45: 714, 1999;
This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Submit an electronic Letter to
the Editor about this paper
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (37)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Nosanchuk, J. S.
Right arrow Articles by Abbott, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Nosanchuk, J. S.
Right arrow Articles by Abbott, G.
Related Collections
Right arrow Proteomics and Protein Markers
Right arrow Automation and Analytical Techniques
(Clinical Chemistry. 1999;45:714.)
© 1999 American Association for Clinical Chemistry, Inc.

Letters

False Increases of Troponin I Attributable to Incomplete Separation of Serum

Jerome S. Nosanchuk

Department of Pathology and Laboratory Medicine, Cayuga Medical Center at Ithaca, 101 Dates Dr., Ithaca, NY 14850, Fax 607-274-4481, E-mail JSN{at}CORNELL.edu


To the Editor:

In the process of establishing a troponin I assay in our laboratory, we found limited data on reference intervals for plasma. Because our laboratory relies heavily on plasma rather than serum to expedite analysis (1), we undertook a parallel study of serum and plasma troponin I concentrations with the Abbott AxSYMTM assay. To our surprise, we found several discordant results (Table 1 ). Reanalysis of the samples reproduced the discrepant results. However, when one of the serum samples was recentrifuged, reanalysis produced results essentially the same as those obtained from the matching plasma sample. After the other discordant serum samples were recentrifuged and reanalyzed, all serum and plasma results were similar. Additional samples, purposely allowed to contain tiny fibrinstrands, also produced increased troponin I results.


View this table:
[in this window]
[in a new window]
  		Table 1. Troponin I results on serum samples following initial centrifugation and after recentrifugation compared with matched plasma samples.

We believe that the antibody either binds nonspecifically to fibrin or that the indicator enzyme is physically trapped by fibrin in the separation matrix. Because incomplete separation of serum can leave fibrin in the sample, falsely increased troponin I concentrations can result.

We concluded that the use of plasma rather than serum essentially eliminates this problem and also allows the samples to be placed on the AxSYM faster, expediting turnaround time by at least 10–15 min. However, if serum is used, the samples must be completely clotted and centrifuged sufficiently to ensure complete separation of the serum from the clot. In our laboratory, we have found that centrifugation at 2000g for 10 min is required for the preparation of fibrin-free serum.


References

  1. Nosanchuk JS, Stull R, Keefner R. The effect of substitution of plasma for serum on chemistry stat turnaround time. Lab Med 1991;22:465-469.

Representatives of Abbott Laboratories respond:

Brad Combs and Glenda Abbott

Abbott Laboratories, 200 Abbott Park Rd., Abbott Park, IL 60064
a Address correspondence to this author at: Abbott Laboratories, 200 Abbott Park Rd., Building AP31, Department 9JW, Abbott Park, IL 60064.


To the Editor:

This letter highlights the important issue of sample preparation and that poor sample integrity can adversely affect assay methodologies, regardless of the highly specific nature of the reagents. For assays using serum, it is important to ensure that complete clot formation has taken place before centrifugation. It should also be noted that some specimens, especially those from patients receiving anticoagulant or thrombolytic therapy, may exhibit increased clotting time. If specimens are centrifuged before complete clot formation, the presence of fibrin may alter results.




The following articles in journals at HighWire Press have cited this article:


Home page
 Clin. Cancer Res.Home page
R. L. Piekarz, A. R. Frye, J. J. Wright, S. M. Steinberg, D. J. Liewehr, D. R. Rosing, V. Sachdev, T. Fojo, and S. E. Bates
Cardiac Studies in Patients Treated with Depsipeptide, FK228, in a Phase II Trial for T-Cell Lymphoma.
Clin. Cancer Res., June 15, 2006; 12(12): 3762 - 3773.
[Abstract] [Full Text] [PDF]

Home page
 Toxicol PatholHome page
K. B. Wallace, E. Hausner, E. Herman, G. D. Holt, J. T. Macgregor, A. L. Metz, E. Murphy, I.Y. Rosenblum, F. D. Sistare, and M. J. York
Serum Troponins as Biomarkers of Drug-Induced Cardiac Toxicity
Toxicol Pathol, January 1, 2004; 32(1): 106 - 121.
[PDF]

Home page
 Eur Heart JHome page
J. Kamblock, L. Payot, B. Iung, P. Costes, T. Gillet, C. Le Goanvic, P. Lionet, B. Pagis, J. Pasche, C. Roy, et al.
Does rheumatic myocarditis really exists? Systematic study with echocardiography and cardiac troponin I blood levels
Eur. Heart J., May 1, 2003; 24(9): 855 - 862.
[Abstract] [Full Text] [PDF]

Home page
 J. Am. Coll. Nutr.Home page
G. A. Brown, M. D. Vukovich, E. R. Martini, M. L. Kohut, W. D. Franke, D. A. Jackson, and D. S. King
Endocrine and Lipid Responses to Chronic Androstenediol-Herbal Supplementation in 30 to 58 Year Old Men
J. Am. Coll. Nutr., October 1, 2002; 20(5): 520 - 528.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
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]

Home page
 Clin. Chem.Home page
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]

Home page
 J. Appl. Physiol.Home page
G. A. Brown, E. R. Martini, B. S. Roberts, M. D. Vukovich, and D. S. King
Acute hormonal response to sublingual androstenediol intake in young men
J Appl Physiol, January 1, 2002; 92(1): 142 - 146.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
P. Beyne, J.-P. Vigier, P. Bourgoin, and M. Vidaud
Comparison of Single and Repeat Centrifugation of Blood Specimens Collected in BD Evacuated Blood Collection Tubes Containing a Clot Activator for Cardiac Troponin I Assay on the ACCESS Analyzer
Clin. Chem., November 1, 2000; 46(11): 1869 - 1870.
[Full Text] [PDF]

Home page
 Clin. Chem.Home page
H. Stiegler, Y. Fischer, J. F. Vazquez-Jimenez, J. Graf, K. Filzmaier, B. Fausten, U. Janssens, A. M. Gressner, and D. Kunz
Lower Cardiac Troponin T and I Results in Heparin-Plasma Than in Serum
Clin. Chem., September 1, 2000; 46(9): 1338 - 1344.
[Abstract] [Full Text] [PDF]

Home page
 Clin. Chem.Home page
C. Galambos, D. S. Brink, D. Ritter, H. D. Chung, M. H. Creer, and K. A. Ford
False-Positive Plasma Troponin I with the AxSYM Analyzer The manager of AxSYM System Integration for Abbott Diagnostic Division responds:
Clin. Chem., July 1, 2000; 46(7): 1014 - 1015.
[Full Text] [PDF]

This Article
Right arrow Extract Freely available
Right arrow Full Text (PDF)
Right arrow Submit an electronic Letter to
the Editor about this paper
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via ISI Web of Science (37)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Nosanchuk, J. S.
Right arrow Articles by Abbott, G.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Nosanchuk, J. S.
Right arrow Articles by Abbott, G.
Related Collections
Right arrow Proteomics and Protein Markers
Right arrow Automation and Analytical Techniques

HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS