Peri-operative troponin monitoring using a prototype high-sensitivity cardiac troponin I (hs-cTnI) assay: comparisons with hs-cTnT and contemporary cTnI assays.

Author(s): Lee GR, Jhanji S, Tarrant H, James S, Pearse RM, Fitzgibbon M

Publication: Ann Clin Biochem, 2014, Vol. 51, Page 258-68

PubMed ID: 24048718 PubMed Review Paper? No

Purpose of Paper

Conclusion of Paper

Studies

1. Study Purpose

   The purpose of this study was to determine the effects of time of collection with respect to gastro-intestinal surgery, method of IV fluid treatment during surgery, patient age and gender, and type of auto analyzer assay on troponin concentrations in serum. Specimens were collected from 135 patients in serum separator tubes, centrifuged, and serum was stored at -70 degrees C until analysis. During surgery, IV fluid treatment was either guided by SV or central venous pressure (CVP).

   Summary of Findings:

   Patient age and gender had significant influences on troponin concentrations measured by the hs-cTnT assay but not the cTnI or hs-cTnI assays, with patients who were 60 years or older showing more cTnT concentrations in the 99th percentile and a significantly higher median cTnT concentration in males than females (p<0.01). Troponin concentrations were higher in the 24 h post-operative specimens than in the pre-operative ones (p<0.05), regardless of IV fluid treatment, and significant increases were noted as early as immediately after surgery using the hs-cTnI assay. Further, troponin levels in specimens collected at 24 h post-op were higher from patients with than without post-operative complications, and this was particularly evident among the SV guided fluid with dopexamine treatment group. The hs-cTnT assay measured a significantly higher number of troponin levels in the 99th percentile, regardless of time of collection or IV treatment group, but the authors note that the influences of patient age and gender on this assay are likely confounding variables.

   Biospecimens

   • Bodily Fluid - Serum
   • Bodily Fluid - Blood

   Preservative Types

   • Frozen

   Diagnoses:

   • Other diagnoses

   Platform:

   Analyte	Technology Platform
   Protein	Clinical chemistry/auto analyzer

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Preaquisition	Diagnosis/ patient condition	Underwent major gastrointestinal surgery Post-operative complications No post-operative complications
   Biospecimen Acquisition	Time of biospecimen collection	Before gastrointestinal surgery Immediately after gastrointestinal surgery 8 h post-operatively 24 h post-operatively
   Clinical chemistry/auto analyzer Specific	Technology platform	ARCHITECT i1000SR hs-cTnI assay Cobas hs-cTnT assay Access 2 cTnI assay
   Preaquisition	Intra-operative fluid administration	CVP guided IV fluid SV guided IV fluid with dopexamine SV guided IV fluid without dopexamine
   Preaquisition	Patient age	< 60 years old 60 years or older
   Preaquisition	Patient gender	Female Male

   View more