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
    Antman, EM
    Tanasijevic, MJ
    Thompson, B
    Schactman, M
    McCabe, CH
    Cannon, CP
    Fischer, GA
    Fung, AY
    Thompson, C
    Wybenga, D
    Braunwald, E
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 1996, 335 (18) : 1342 - 1349
  • [2] Future biomarkers for detection of ischemia and risk stratification in acute coronary syndrome
    Apple, FS
    Wu, AHB
    Mair, J
    Ravkilde, J
    Panteghini, M
    Tate, J
    Pagani, F
    Christenson, RH
    Mockel, M
    Danne, O
    Jaffe, AS
    [J]. 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
    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
    [J]. NEW ENGLAND JOURNAL OF MEDICINE, 2002, 346 (26) : 2047 - 2052
  • [5] STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT
    BLAND, JM
    ALTMAN, DG
    [J]. 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
    Catellier, Diane J.
    Aleksic, Nena
    Folsom, Aaron R.
    Boerwinkle, Eric
    [J]. CLINICAL CHEMISTRY, 2008, 54 (08) : 1363 - 1371
  • [7] Serial measure of cardiac troponin T levels for prediction of clinical events in decompensated heart failure
    Del Carlo, CH
    Pereira-Barretto, AC
    Cassaro-Strunz, C
    Latorre, MDDO
    Ramires, JAF
    [J]. JOURNAL OF CARDIAC FAILURE, 2004, 10 (01) : 43 - 48
  • [8] Cardiac troponins: IT upgrade for the heart
    Donnelly, R
    Millar-Craig, MW
    [J]. 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