Autoantibody prevalence with an improved immunoassay for detecting cardiac troponin-specific autoantibodies
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Tanja Savukoski
,
Tuomo Ilva
Abstract
Background: Cardiac troponin-specific autoantibodies (cTnAAb) can interfere with the measurement of cardiac troponin I (cTnI) by immunoassays used for the diagnosis of myocardial infarction (MI). Here, an improved version of a previous autoantibody assay was validated and used to evaluate the cTnAAb prevalence in a cohort of consecutive chest pain patients presenting to an emergency department.
Methods: Admission samples from 510 patients with suspected MI were analyzed in parallel with two sandwich-type cTnAAb assays based on different cTnI epitopes used to capture cardiac troponin-bound cTnAAbs.
Results: Sample-specific backgrounds were lower for the new assay than for the old assay (median 1225 vs. 2693 counts, p<0.001). Net signals of cTnAAb-positive samples were higher for the new assay than for the old assay (median 5076 vs. 3921 counts, p<0.001). Of all patients, 9.2% were cTnAAb-positive for the new assay and 7.3% for the old assay (p=0.013). Previous cardiac problems were not associated with cTnAAb status and cTnAAb status did not correlate with the 12-month outcome.
Conclusions: With our new and more sensitive autoantibody assay, approximately one out of ten patients who presented to the initial cardiac triage had detectable amounts of cTnAAbs in the circulation. Because these cTnAAbs can interfere with state-of-the-art cTnI assays, their high prevalence should be acknowledged by clinical chemists, physicians, and kit manufacturers.
We gratefully acknowledge Pirjo Laaksonen and Yifeng Li for their excellent technical assistance at the Department of Biotechnology, University of Turku. This work was supported by DIA-NET, the Graduate School of Advanced Diagnostic Technologies and Applications.
Conflict of interest statement
Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
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©2014 by Walter de Gruyter Berlin Boston
Artikel in diesem Heft
- Frontmatter
- Editorial
- The ten commandments of laboratory testing for emergency physicians
- Review
- Critical role of RAGE in lung physiology and tumorigenesis: a potential target of therapeutic intervention?
- Opinion Papers
- Do we really need high-sensitive troponin immunoassays in the emergency department? Definitely, yes!
- Do we really need high-sensitivity troponin immunoassays in the emergency department? Maybe not
- General Clinical Chemistry and Laboratory Medicine
- Cortisol and cortisone ratio in urine: LC-MS/MS method validation and preliminary clinical application
- Urinary neutrophil gelatinase-associated lipocalin (NGAL) excretion increases in normal pregnancy but not in preeclampsia
- Influence of urine volume on the assessment of intestinal permeability in affected children by multiple sugar probes
- Measurement of amino terminal propeptide of type III procollagen (PIIINP) employing the ADVIA Centaur platform. Validation, reference interval and comparison to UniQ RIA
- Cancer Diagnostics
- Enrichment and enumeration of circulating tumor cells by efficient depletion of leukocyte fractions
- Immunological screening for tumor cells in serous body fluids has added value with the CELL-DYN Sapphire
- Cardiovascular Diseases
- The value of clinical and laboratory diagnostics for chest pain patients at the emergency department
- The concentration of high-sensitivity troponin I, galectin-3 and NT-proBNP substantially increase after a 60-km ultramarathon
- Autoantibody prevalence with an improved immunoassay for detecting cardiac troponin-specific autoantibodies
- Increased B-type natriuretic peptide levels in early-onset versus late-onset preeclampsia
- Association of the GCKR rs780094 polymorphism with metabolic traits including carotid intima-media thickness in Japanese community-dwelling men, but not in women
- Infectious Diseases
- Analysis of antibody response (IgM, IgG, IgG3) to Chikungunya virus using panel of peptides derived from envelope protein for serodiagnosis
- Letters to the Editor
- A short story on how the H-index may change the fate of scientists and scientific publishing
- A new and effective way for preventing pre-analytical laboratory errors
- Digital immunofluorescence enables automated detection of antinuclear antibody endpoint titers avoiding serial dilution
- Multicenter method evaluation of the ARK™ Methotrexate Immunoassay
- Haemoglobinopathies in nonendemic areas in recent years
- Clinical implications of a recent adjustment to the high-sensitivity cardiac troponin T assay: some results
- Effect of recalibration of the hs-TnT assay on diagnostic performance
Artikel in diesem Heft
- Frontmatter
- Editorial
- The ten commandments of laboratory testing for emergency physicians
- Review
- Critical role of RAGE in lung physiology and tumorigenesis: a potential target of therapeutic intervention?
- Opinion Papers
- Do we really need high-sensitive troponin immunoassays in the emergency department? Definitely, yes!
- Do we really need high-sensitivity troponin immunoassays in the emergency department? Maybe not
- General Clinical Chemistry and Laboratory Medicine
- Cortisol and cortisone ratio in urine: LC-MS/MS method validation and preliminary clinical application
- Urinary neutrophil gelatinase-associated lipocalin (NGAL) excretion increases in normal pregnancy but not in preeclampsia
- Influence of urine volume on the assessment of intestinal permeability in affected children by multiple sugar probes
- Measurement of amino terminal propeptide of type III procollagen (PIIINP) employing the ADVIA Centaur platform. Validation, reference interval and comparison to UniQ RIA
- Cancer Diagnostics
- Enrichment and enumeration of circulating tumor cells by efficient depletion of leukocyte fractions
- Immunological screening for tumor cells in serous body fluids has added value with the CELL-DYN Sapphire
- Cardiovascular Diseases
- The value of clinical and laboratory diagnostics for chest pain patients at the emergency department
- The concentration of high-sensitivity troponin I, galectin-3 and NT-proBNP substantially increase after a 60-km ultramarathon
- Autoantibody prevalence with an improved immunoassay for detecting cardiac troponin-specific autoantibodies
- Increased B-type natriuretic peptide levels in early-onset versus late-onset preeclampsia
- Association of the GCKR rs780094 polymorphism with metabolic traits including carotid intima-media thickness in Japanese community-dwelling men, but not in women
- Infectious Diseases
- Analysis of antibody response (IgM, IgG, IgG3) to Chikungunya virus using panel of peptides derived from envelope protein for serodiagnosis
- Letters to the Editor
- A short story on how the H-index may change the fate of scientists and scientific publishing
- A new and effective way for preventing pre-analytical laboratory errors
- Digital immunofluorescence enables automated detection of antinuclear antibody endpoint titers avoiding serial dilution
- Multicenter method evaluation of the ARK™ Methotrexate Immunoassay
- Haemoglobinopathies in nonendemic areas in recent years
- Clinical implications of a recent adjustment to the high-sensitivity cardiac troponin T assay: some results
- Effect of recalibration of the hs-TnT assay on diagnostic performance
