Sources of Variability in Measurements of Cardiac Troponin T in a Community-Based Sample: The Atherosclerosis Risk in Communities Study

被引:74
作者
Agarwal, Sunil K. [3 ]
Avery, Christy L.
Ballantyne, Christie M. [4 ]
Catellier, Diane [2 ]
Nambi, Vijay [4 ]
Saunders, Justin [4 ]
Sharrett, A. Richey [5 ]
Coresh, Josef [5 ]
Heiss, Gerardo [1 ]
Hoogeveen, Ron C. [4 ]
机构
[1] Univ N Carolina, Sch Publ Hlth, Dept Epidemiol, Chapel Hill, NC 27514 USA
[2] Univ N Carolina, Dept Biostat, Chapel Hill, NC 27514 USA
[3] Univ Pittsburgh, Dept Internal Med, Pittsburgh, PA USA
[4] Baylor Coll Med, Dept Med, Houston, TX 77030 USA
[5] Johns Hopkins Sch Publ Hlth, Dept Epidemiol, Baltimore, MD USA
关键词
CHRONIC HEART-FAILURE; ACUTE CORONARY SYNDROMES; NATRIURETIC PEPTIDE; MYOCARDIAL DAMAGE; PROGNOSTIC VALUE; MARKERS; MORTALITY; STRATIFICATION; COMBINATION; DYSFUNCTION;
D O I
10.1373/clinchem.2010.159350
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
BACKGROUND: Application of cardiac troponin T (cTnT) as a marker of myocyte damage requires knowledge of its measurement variability. Using a highly sensitive assay for measurement, we evaluated the long-term storage stability of plasma cTnT at -70 degrees C and the sources of cTnT variability. METHODS: Samples from the Atherosclerosis Risk in Communities study collected in 1996-1998 and 2005-2006 were assayed centrally to quantify variability in cTnT attributable to processing (replicates from same blood draw, n = 87), laboratory (replicates after freeze thaw, n = 29), short-term (n = 40) and long-term biological variation (repeat visit, n = 38), and degradation in frozen storage (n = 7677). RESULTS: Approximately 30% of this population-based cohort had cTnT concentrations below the detection limit (3 ng/L). Reliability coefficients for all paired comparisons exceeded 0.93 except for samples drawn 8 years apart (r = 0.36). Sources of cTnT variation (as CVs) were: laboratory, 2.1% and 11.2% in those with and without heart failure, respectively; processing, 18.3%; biological, 16.6% at 6 weeks and 48.4% at 8 years. The reference change value at 6 weeks (68.5%) indicated that 4 samples are needed to determine a homeostatic set point within +/- 25%. The estimated cTnT degradation rate over the first year in long-term frozen storage was 0.36 ng/L per year. CONCLUSIONS: cTnT was detectable in approximately 70% of community-dwelling middle-aged study participants and stable in -70 degrees C storage. The variability in cTnT attributable to 1 freeze-thaw cycle is of small magnitude. The observed high laboratory and intraindividual (biological) reliability of cTnT support its use for population-based research, and in clinical settings that rely on classification and serial measurements. (C) 2011 American Association for Clinical Chemistry
引用
收藏
页码:891 / 897
页数:7
相关论文
共 24 条
[1]   Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes [J].
Antman, EM ;
Tanasijevic, MJ ;
Thompson, B ;
Schactman, M ;
McCabe, CH ;
Cannon, CP ;
Fischer, GA ;
Fung, AY ;
Thompson, C ;
Wybenga, D ;
Braunwald, E .
NEW ENGLAND JOURNAL OF MEDICINE, 1996, 335 (18) :1342-1349
[2]   Future biomarkers for detection of ischemia and risk stratification in acute coronary syndrome [J].
Apple, FS ;
Wu, AHB ;
Mair, J ;
Ravkilde, J ;
Panteghini, M ;
Tate, J ;
Pagani, F ;
Christenson, RH ;
Mockel, M ;
Danne, O ;
Jaffe, AS .
CLINICAL CHEMISTRY, 2005, 51 (05) :810-824
[3]  
*ARIC CAR MRI STUD, MAN 2 FIELD CTR PROC
[4]   Troponin T levels in patients with acute coronary syndromes, with or without renal dysfunction [J].
Aviles, RJ ;
Askari, AT ;
Lindahl, B ;
Wallentin, L ;
Jia, G ;
Ohman, EM ;
Mahaffey, KW ;
Newby, LK ;
Califf, RM ;
Simoons, ML ;
Topol, EJ ;
Lauer, MS ;
Berger, P .
NEW ENGLAND JOURNAL OF MEDICINE, 2002, 346 (26) :2047-2052
[5]   STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT [J].
BLAND, JM ;
ALTMAN, DG .
LANCET, 1986, 1 (8476) :307-310
[6]   Atherosclerosis Risk in Communities (ARIC) carotid MRI flow cytometry study of monocyte and platelet markers: Intraindividual variability and reliability [J].
Catellier, Diane J. ;
Aleksic, Nena ;
Folsom, Aaron R. ;
Boerwinkle, Eric .
CLINICAL CHEMISTRY, 2008, 54 (08) :1363-1371
[7]   Serial measure of cardiac troponin T levels for prediction of clinical events in decompensated heart failure [J].
Del Carlo, CH ;
Pereira-Barretto, AC ;
Cassaro-Strunz, C ;
Latorre, MDDO ;
Ramires, JAF .
JOURNAL OF CARDIAC FAILURE, 2004, 10 (01) :43-48
[8]   Cardiac troponins: IT upgrade for the heart [J].
Donnelly, R ;
Millar-Craig, MW .
LANCET, 1998, 351 (9102) :537-539
[9]  
Fleiss J.L., 2003, The measurement of interrater agreement Statistical methods for rates and proportions, P598, DOI DOI 10.1002/0471445428
[10]  
FRASER CG, 1989, CRIT REV CL LAB SCI, V27, P409