Key result
Testing plasma specimens on four different troponin I assays resulted in 44% of patients being categorized differently by instrument-specific cutoff values, despite high correlations (R2≥0.94).
Why the study?
Does the choice of troponin I assay platform and cutoff value affect patient categorization in suspected acute myocardial infarction?
Observational
Does the choice of troponin I assay platform and cutoff value affect patient categorization in suspected acute myocardial infarction?
Different troponin I assays and cutoff values lead to significant reclassification of patients, highlighting the need for clinician education when changing laboratory platforms.
Supports caution with assay platform switches in suspected MI; leaves open standardization effects on diagnostic accuracy.
Measurement of troponin concentration is important for evaluating patients with suspected acute myocardial infarction or cardiac damage, with results interpreted relative to method-specific cutoff values. This study evaluates changes in sample categorization and patient management based on different test methods. Plasma specimens were tested for troponin I on 4 different instrument platforms, with chart review. Results were compared with cutoff values corresponding to the 99th percentile reference interval and the concentration having 10% coefficient of variation. Significant correlations were observed among instrument platforms (R2≥0.94). However, 44% of patients were categorized differently by instrument-specific cutoff values. The use of higher sensitivity assays was associated with 47% to 106% increase in number of results exceeding both the 99th percentile and 10% CV cutoffs. Changing instrument platforms can cause reclassifications of patient results. Laboratories adopting new troponin measurement methods should perform clinician education regarding its interpretation and the importance of serial testing.
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Bonham et al. (2009) conducted an observational in Suspected acute myocardial infarction or cardiac damage. Four commercially available troponin I assays vs. Different instrument platforms was evaluated on Sample categorization based on different test methods. Testing plasma specimens on four different troponin I assays resulted in 44% of patients being categorized differently by instrument-specific cutoff values, despite high correlations (R2≥0.94).
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