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Letters to the Editor| Volume 37, ISSUE 8, P1292-1293, August 2021

An Approach to Investigating Discordant High-Sensitivity Cardiac Troponin I Results

Published:November 17, 2020DOI:https://doi.org/10.1016/j.cjca.2020.11.005
An Approach to Investigating Discordant High-Sensitivity Cardiac Troponin I Results
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      With high-sensitivity cardiac troponin (hsTn) testing being the standard test for the detection of myocardial injury, there has been a growing interest in understanding why differences exist between assays, with a particular focus on macrocomplexes.
      • Warner J.V.
      • Marshall G.A.
      High incidence of macrotroponin I with a high-sensitivity troponin I assay.
      Clin Chem Lab Med. 2016; 5: 1821-1829
      , 
      • Kavsak P.A.
      • Roy C.
      • Malinowski P.
      • et al.
      Macrocomplexes and discordant high-sensitivity cardiac troponin concentrations.
      Ann Clin Biochem. 2018; 5: 500-504
      , 
      • Lam L.
      • Aspin L.
      • Heron R.C.
      • et al.
      Discrepancy between cardiac troponin assays due to endogenous antibodies.
      Clin Chem. 2020; 6: 445-454
      Macrocomplexes typically consist of immunoglobulin-bound cardiac troponin, which may yield chronically high, nonchanging hsTn concentrations in patients.
      • Warner J.V.
      • Marshall G.A.
      High incidence of macrotroponin I with a high-sensitivity troponin I assay.
      Clin Chem Lab Med. 2016; 5: 1821-1829
      , 
      • Kavsak P.A.
      • Roy C.
      • Malinowski P.
      • et al.
      Macrocomplexes and discordant high-sensitivity cardiac troponin concentrations.
      Ann Clin Biochem. 2018; 5: 500-504
      , 
      • Lam L.
      • Aspin L.
      • Heron R.C.
      • et al.
      Discrepancy between cardiac troponin assays due to endogenous antibodies.
      Clin Chem. 2020; 6: 445-454
      However, there is variability among hsTn assays with respect to detection of these macrocomplexes as well as their clinical significance and impact.
      • Warner J.V.
      • Marshall G.A.
      High incidence of macrotroponin I with a high-sensitivity troponin I assay.
      Clin Chem Lab Med. 2016; 5: 1821-1829
      , 
      • Kavsak P.A.
      • Roy C.
      • Malinowski P.
      • et al.
      Macrocomplexes and discordant high-sensitivity cardiac troponin concentrations.
      Ann Clin Biochem. 2018; 5: 500-504
      , 
      • Lam L.
      • Aspin L.
      • Heron R.C.
      • et al.
      Discrepancy between cardiac troponin assays due to endogenous antibodies.
      Clin Chem. 2020; 6: 445-454
      , 
      • Kavsak P.A.
      • Tandon V.
      • Ainsworth C.
      A Three-site immunoassay for high-sensitivity cardiac troponin I with low immunoreactivity for macrocomplexes.
      Clin Chem. 2020; 6: 854-855
      To this end, we sought to assess the comparability of the Ortho Clinical Diagnostics hsTnI assay (low recovery for macrocomplexes) and the Abbott Diagnostics hsTnI assay (higher detection of macrocomplexes) in plasma samples with hsTnI clinically ordered.
      • Kavsak P.A.
      • Tandon V.
      • Ainsworth C.
      A Three-site immunoassay for high-sensitivity cardiac troponin I with low immunoreactivity for macrocomplexes.
      Clin Chem. 2020; 6: 854-855
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      References

        • Warner J.V.
        • Marshall G.A.
        High incidence of macrotroponin I with a high-sensitivity troponin I assay.
        Clin Chem Lab Med. 2016; 5: 1821-1829
        View in Article
        • Kavsak P.A.
        • Roy C.
        • Malinowski P.
        • et al.
        Macrocomplexes and discordant high-sensitivity cardiac troponin concentrations.
        Ann Clin Biochem. 2018; 5: 500-504
        View in Article
        • Lam L.
        • Aspin L.
        • Heron R.C.
        • et al.
        Discrepancy between cardiac troponin assays due to endogenous antibodies.
        Clin Chem. 2020; 6: 445-454
        View in Article
        • Kavsak P.A.
        • Tandon V.
        • Ainsworth C.
        A Three-site immunoassay for high-sensitivity cardiac troponin I with low immunoreactivity for macrocomplexes.
        Clin Chem. 2020; 6: 854-855
        View in Article

      Article info

      Publication history

      Published online: November 17, 2020
      Accepted: November 10, 2020
      Received: October 9, 2020

      Identification

      DOI: https://doi.org/10.1016/j.cjca.2020.11.005

      Copyright

      © 2020 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

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