Cancer Diagnosis Program | Biorepositories and Biospecimen Research Branch

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Influence of hemolysis on troponin testing: studies on Beckman Coulter UniCel Dxl 800 Accu-TnI and overview of the literature.

Author(s): Lippi G, Avanzini P, Dipalo M, Aloe R, Cervellin G

Publication: Clin Chem Lab Med, 2011, Vol. 49, Page 2097-2100

PubMed ID: 21892912 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 mechanically induced hemolysis on Accu-TnI measurements in plasma. Specimens were separated into three aliquots, the first of which was centrifuged and analyzed, while the second and third aliquots were aspirated through a 0.5 mL syringe equipped with a 30 gauge needle 1 and 2 times, respectively, inducing hemolysis prior to centrifugation and analysis.

   Summary of Findings:

   When unhemolyzed specimens had Accu-TnI values >0.20 ug/L, aliquots subjected to mechanically induced hemolysis by aspiration through a fine needle once or twice showed median decreases in Accu-TnI values of 10 and 17%, respectively. These decreases did not exceed the acceptable 20% variation to be viewed as clinically significant in any of the specimens aspirated once, but the decreases exceeded 20% in 3 of the 12 aliquots aspirated twice. When unhemolyzed specimens had Accu-TnI values <0.04 ug/L, mechanically induced hemolysis did not change the Accu-TnI measurements. In conclusion, Accu-TnI values decreased in hemolyzed specimens when initial values were >0.20 ug/L, but clinical significance was only reached when cell-free hemoglobin was >16.5 g/L (aliquots aspirated twice).

   Biospecimens

   • Bodily Fluid - Plasma
   • Bodily Fluid - Blood

   Preservative Types

   • None (Fresh)

   Diagnoses:

   • Not specified

   Platform:

   Analyte	Technology Platform
   Protein	Clinical chemistry/auto analyzer
   Protein	Spectrophotometry
   Cell count/volume	Spectrophotometry

   Pre-analytical Factors:

   Classification	Pre-analytical Factor	Value(s)
   Biospecimen Aliquots and Components	Biospecimen components	<0.5 g/L cell-free hemoglobin 9.5-16.0 g/L cell-free hemoglobin 16.5-29.5 g/L cell-free hemoglobin
   Preaquisition	Biomarker level	Accu-TnI values <0.04 ug/L Accu-TnI values >0.20 ug/L
   Biospecimen Aliquots and Components	Hemolysis	Fine needle aspiration-induced Not induced

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