Not T too! False elevations in high-sensitivity cardiac troponin T (hs-TnT) following specimen transport
Copyright © 2022 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved..
Though false elevations attributed to preanalytical specimen handling have been widely reported for Troponin I (TnI), Troponin T (TnT) has appeared more robust to falsely elevated Tn. We describe reproducible false elevations in high sensitivity TnT (hs-TnT) in specimens after courier transport in plasma separator tubes (PST) off-site for testing. Hs-TnT was measured under 5 different conditions: 1) at collection location (N = 24); 2) after transport upright in racks (N = 66); 3) after transport with no control over tube agitation (N = 69); 4) on transported aliquots (N = 84); or 5) immediately after transport with no control over tube agitation (N = 16), followed by keeping the specimen upright and re-measuring at 1hr, 2hr, 4hr, and 20-24hrs (N = 6). To assess the degree of discrepancy, plasma from the original PST was aliquotted, re-centrifuged, potential debris removed, and hs-TnT re-measured. 43% of PST specimens collected offsite and transported with no control over tube agitation had clinically significant false elevations of hs-TnT which subsequently decreased following aliquotting and re-centrifugation (median decrease = 9.9 ng/L). Onsite testing or transported aliquots demonstrated no discrepancy. After being kept upright, discrepant specimens were not different from re-centrifuged aliquots by 4hrs (p = 0.6141, repeated measures ANOVA with Dunn's multiple comparisons). Clinically significant false elevations of hs-TnT occurred in approximately 40% of separated PSTs that were transported in containers where specimens are transported with no control over tube agitation. This interference does not occur if plasma is aliquoted or if hs-TnT is tested at the collection site. In order to prevent these false elevations, and their potential patient impact on the diagnosis of acute myocardial infarction, specimens for hs-TnT measurement should be aliquoted at the collection location prior to transport.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:115 |
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| Enthalten in: |
Clinical biochemistry - 115(2023) vom: 26. Mai, Seite 86-91 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Paul, Heather A [VerfasserIn] |
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| Links: |
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| Themen: |
(3–6): Preanalytical |
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| Anmerkungen: |
Date Completed 11.04.2023 Date Revised 11.04.2023 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.clinbiochem.2022.08.008 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Not T too! False elevations in high-sensitivity cardiac troponin T (hs-TnT) following specimen transport |
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| 520 | |a Copyright © 2022 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved. | ||
| 520 | |a Though false elevations attributed to preanalytical specimen handling have been widely reported for Troponin I (TnI), Troponin T (TnT) has appeared more robust to falsely elevated Tn. We describe reproducible false elevations in high sensitivity TnT (hs-TnT) in specimens after courier transport in plasma separator tubes (PST) off-site for testing. Hs-TnT was measured under 5 different conditions: 1) at collection location (N = 24); 2) after transport upright in racks (N = 66); 3) after transport with no control over tube agitation (N = 69); 4) on transported aliquots (N = 84); or 5) immediately after transport with no control over tube agitation (N = 16), followed by keeping the specimen upright and re-measuring at 1hr, 2hr, 4hr, and 20-24hrs (N = 6). To assess the degree of discrepancy, plasma from the original PST was aliquotted, re-centrifuged, potential debris removed, and hs-TnT re-measured. 43% of PST specimens collected offsite and transported with no control over tube agitation had clinically significant false elevations of hs-TnT which subsequently decreased following aliquotting and re-centrifugation (median decrease = 9.9 ng/L). Onsite testing or transported aliquots demonstrated no discrepancy. After being kept upright, discrepant specimens were not different from re-centrifuged aliquots by 4hrs (p = 0.6141, repeated measures ANOVA with Dunn's multiple comparisons). Clinically significant false elevations of hs-TnT occurred in approximately 40% of separated PSTs that were transported in containers where specimens are transported with no control over tube agitation. This interference does not occur if plasma is aliquoted or if hs-TnT is tested at the collection site. In order to prevent these false elevations, and their potential patient impact on the diagnosis of acute myocardial infarction, specimens for hs-TnT measurement should be aliquoted at the collection location prior to transport | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a (3–6): Preanalytical | |
| 650 | 4 | |a Agitation | |
| 650 | 4 | |a False positive | |
| 650 | 4 | |a Specimen transport | |
| 650 | 4 | |a Troponin | |
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| 650 | 7 | |a Troponin I |2 NLM | |
| 700 | 1 | |a Chi, Qingli |e verfasserin |4 aut | |
| 700 | 1 | |a Gifford, Jessica L |e verfasserin |4 aut | |
| 700 | 1 | |a Seiden-Long, Isolde |e verfasserin |4 aut | |
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