Effect of anticoagulants on high sensitivity quantitative determination of cardiac troponin I

Authors

  • Anothai Neam-In Department of Clinical Pathology, Phrae Hospital
  • Natthapak Sillawatthumrong Department of Medical Technology, School of Allied Health Sciences, University of Phayao, Phayao

Keywords:

anticoagulant, troponin I, Acute Myocardial Infraction

Abstract

Background: High sensitivity quantitative determination of cardiac troponin I, usually use for Acute Myocardial Infraction diagnosis.  There was reported that plasma specimen could use for troponin I determination and take a short time to prepare the specimen.  From the above information, resulting in study the effect of lithium heparin and ethylene diamine tetra acetate (EDTA) as an anticoagulant for collecting the data to create the guidelines for specimen collection in Phare hospital.

Objective: The aim of this study was to evaluate the effect of anticoagulant on high sensitivity quantitative determination of cardiac troponin I.

Study design:  The descriptive study on High sensitivity quantitative determination of cardiac troponin I was performed by using specimen without the anticoagulant compared with the heparinized and EDTA specimen.  The case were 40 blood donors of Phare hospital, during the period from 10th October 2022 to 30th December 2022.

Results: The result found that the troponin I levels after specimen collected for 30, 60 and 90 minutes in the same type of samples showed no different values.  The comparison between heparinized blood and EDTA blood at 30 minutes showed no different in average values.  Furthermore, the average values of clotted blood and EDTA blood showed a significantly different values in each duration time at p-value 0.007, 0.005 and 0.004004 respectively.                        

Conclusion:  This study illustrated that the specimen from clotted blood and lithium heparinized blood were a suitable specimen for troponin I determination. 

Key words:  anticoagulant, troponin I, Acute Myocardial Infraction

References

ณีรนุช พลูชนะ, ถวัลย์ ฤกษ์งาม, สมศักดิ์ ฟองสุภา. การศึกษาเปรียบเทียบความแม่นยำวิธีการวิเคราะห์ คาร์ดิแอกโทรโปนินระหว่าง High-Sensitivity Cardiac Troponin I และ High Sensitivity Cardiac Troponin T ในการวินิจฉัยภาวะกล้ามเนื้อหัวใจตายเฉียบพลันชนิด NSTEMI. วารสารการแพทย์โรงพยาบาลอุดรธานี 2562;27(3):272-78.

Adams JE, Abendschein DR, Jaffe AS. Biochemical markers of myocardial injury: is MB Creatine kinase the choice for the 1990. Circulation 1993;88(2):750-63.

Apple FS. Acute myocardial infarction and coronary reperfusion. Serum cardiac markers for the 1990s. Ameri J Clin Pathol 1992;97(2):217-26.

Katus HA, Scheffold T, Remppis A, Zehlein J. Proteins of the troponin complex. Lad Med 1992;23(5):311-7.

Adams JE, Schechtman K, Landt Y, Ladenson JH, Jaffe AS. Comparable detection of acute myocardial Infarction by creatine kinase MB isoenzyme and cardiac troponin I. Clin Chem 1994;40(7Pt1):1291-5.

Wilkinson JM, Grand RJA. Comparison of aminoacid sequence of troponin I from different Striated muscles. Nature 1987;271(5640):31-5.

Vichaibun V. Use of cardiac troponins as strong markers for patients with acute coronary syndrome. Rangsit Journal of Arts Sciences 2014;4(2): 163-75.

Thygesen K, Mair J, Katus H, Plebani M, Venge P, Collinson P, et al. Recommenda- tions for the use of cardiac troponin Measurement in acute cardiac care. Eur Heart J 2010;31(18):2197-204.

Than M, Herbert M, Flaws D, Cullen L, Hess E, Hollander JE, et al. What is an acceptable risk of major adverse cardiac Event in chest pain patients soon after discharge from the emergency department a Clinical survey. Lnt J Cardiol 2013;166(3): 752-4.

Than M, Cullen L, Aldous S, Parsonage WA, Reid CM, Greenslade J, et al. 2-Hour accelerated diagnostic protocol to assess patients with chest pain symptoms using contemporary troponins as the only biomarker: the ADAPT trial. J Am Coll Cardiol 2012;59(23):2019-98.

การตรวจ Troponin เพื่อใช้เป็นแนวทางในการส่งตรวจหลอดเลือดหัวใจด้วย CCTA [อินเตอร์เน็ต]. 2565[เข้าถึงเมื่อ 10 มิถุนายน 2565]. เข้าถึงได้จาก: https:// cimjournal.com/medical-news/การตรวจ-troponin-เพื่อใช้เป็น/

Roffi M, Patrono C, Collet JP, Mueller C, Valgimigli M, Andreotti F, et al. 2015 ESC guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Kardiol Pol 2015;73(12):1027-94

Jarolim P. High sensitivity cardiac troponin assays in the clinical laboratories. Clin Chem Lab Med 2014. doi: 10.1515/cclm-2014-0565

Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD. Third universal definition of myocardial infarction. Eur Heart J 2012;33(20):2551-67.

Beckman Coulter. ACCESS Immunoassay System Instruction For Use C41140 C. n.p. ACCESS HIGH Sensitivity Troponin I; 2017.

World Health Oganization. Use of Anticoagulants in Diagnostic Laboratory Investigations. Geneva: WHO; 2002. Avialable from ://apps.who.int/ iris/ handle/10665/65957

Access hsTnI High Sensitivity Troponin I. Beckman Coulter Access Immunoassay Systems Instruction For Use C11140 C 2017:1-18.

Hamm CW, Goldmann BU, Heeschen C, Kreymann G, Berger J, Meinertz T. Emergency room triage of patients with acute chest pain by means of rapid testing for cardiac troponin T or troponin I. N Engl J Med. 1997;337(23):1648-53.

Osredkar J, Krivic K, Fabjan T, Kumer K, Trsan J, Poljancic L, et al. Point-of-care high-sensitivity assay on PATHFAST as the backup in the emergency room. Med Access Point care 2021; 5:1-8.doi: 10.1177/23992 026211055095

บุญศรี มหากิตติคุณ. การเจาะเลือดและการใช้สารกันเลือดแข็ง [อินเตอร์เน็ต]. กรุงเทพฯ: จุฬาลงกรณ์มหาวิทยาลัย; ม.ป.ป. เข้าถึงได้จาก: http://www. Microscopy.ahs.chula.ac.th/newmicros/lecture/blood collecting.pdf

Banfi G, Salvagno GL, Lippi G. The role of ethylenediamine tetra acetic acid (EDTA) as in vitro anticoagulant for diagnostic purpose. Clin Chem Lab Med 2007;45(5):565-76.

ปนัดดา มีสุขประดับ. ความคงตัวของค่าทางเคมีในพลาสมาที่มีเฮปารินเป็นสารกันเลือดแข็งและสัมผัสเซลล์. วารสารเทคนิคการแพทย์และกายภาพบำบัด 2555;24(1):41-3.

Published

2023-08-07

How to Cite

เนียมอินทร์ อ., & ศีลวัตธำรง ณ. . (2023). Effect of anticoagulants on high sensitivity quantitative determination of cardiac troponin I . (PMJCS) Phrae Medical Journal and Clinical Sciences, 31(1), 73–85. Retrieved from https://thaidj.org/index.php/jpph/article/view/13471

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Original Article