Investigating outlier rates of cardiac troponin I and troponin T assays: A systematic review
- PMID: 38205298
- PMCID: PMC10776999
- DOI: 10.1016/j.heliyon.2023.e23788
Investigating outlier rates of cardiac troponin I and troponin T assays: A systematic review
Abstract
Objectives: This review aimed to harmoniously summarize and compare outlier rates for various cardiac troponin (cTn) assays, including high-sensitivity-cTn (hs-cTn) assays and contemporary cTn (generation of assays prior to hs-cTn ones) assays, from the published studies.
Methods: The PRISMA guidelines were utilized to perform this systematic review. Five databases, including PubMed, Scopus, Embase, Cochrane Library, and Web of Science, were searched using specific keywords up to June 30th, 2023. Studies reporting specifically calculated outlier rates for cTn assays when conducting in-vitro diagnosis in human samples were included. Selected studies were then further assessed using the GRADE tool.
Results: Thirteen studies were included. The data from the studies were summarized statistically in this review. The results showed substantial evidence of improved analytical robustness or reduced respective mean rates of outliers, critical outliers, and analytical outliers for hs-cTn assays (0.14 %, 0.18 %, and 0.18 %) compared to contemporary cTn assays (0.63 %, 0.71 %, and 0.50 %).
Conclusion: The findings offer promisingly provide a comprehensive reference for laboratory scientists and clinical staff in choosing the most suitable cTn assay for patient care regrading outlier rates. Besides, this review reveals the advancements of hs-cTn assays with lower outlier rates than contemporary cTn assays. The emerging challenges for continuously improving analytical robustness of cTn assays are also elaborated.
Keywords: Immunological assay; Molecular biomarker; Outlier; Troponin.
© 2023 The Authors.
Conflict of interest statement
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
Figures
Similar articles
-
Comparison of cardiac TnI outliers using a contemporary and a high-sensitivity assay on the Abbott Architect platform.Ann Clin Biochem. 2014 Jul;51(Pt 4):507-11. doi: 10.1177/0004563214534637. Epub 2014 Apr 22. Ann Clin Biochem. 2014. PMID: 24757182
-
High-sensitivity cardiac troponin assays: From improved analytical performance to enhanced risk stratification.Crit Rev Clin Lab Sci. 2017 May;54(3):143-172. doi: 10.1080/10408363.2017.1285268. Epub 2017 May 1. Crit Rev Clin Lab Sci. 2017. PMID: 28457177 Review.
-
Cardiac troponins: 25 years on the stage and still improving their clinical value.Crit Rev Clin Lab Sci. 2017 Nov-Dec;54(7-8):551-571. doi: 10.1080/10408363.2017.1410777. Epub 2017 Dec 11. Crit Rev Clin Lab Sci. 2017. PMID: 29226754
-
Independent and combined effects of biotin and hemolysis on high-sensitivity cardiac troponin assays.Clin Chem Lab Med. 2021 Mar 25;59(8):1431-1443. doi: 10.1515/cclm-2021-0124. Print 2021 Jul 27. Clin Chem Lab Med. 2021. PMID: 33761581
-
Early high-sensitivity troponin elevation and short-term mortality in sepsis: a systematic review with meta-analysis.Crit Care. 2025 Feb 14;29(1):76. doi: 10.1186/s13054-025-05249-2. Crit Care. 2025. PMID: 39953561 Free PMC article.
Cited by
-
Minimizing bias when using artificial intelligence in critical care medicine.J Crit Care. 2024 Aug;82:154796. doi: 10.1016/j.jcrc.2024.154796. Epub 2024 Mar 29. J Crit Care. 2024. PMID: 38552451 Free PMC article. No abstract available.
References
-
- Amundson B.E., Apple F.S. Cardiac troponin assays: a review of quantitative point-of-care devices and their efficacy in the diagnosis of myocardial infarction. Clin. Chem. Lab. Med. 2015;53:665–676. https://10.1515/cclm-2014-0837 - DOI - PubMed
-
- Apple F.S., Jesse R.L., Newby L.K., Wu A.H., Christenson R.H. B. National Academy of Clinical, and I.C.f.S.o.M.o.C. Damage. National academy of clinical biochemistry and IFCC committee for standardization of markers of cardiac damage laboratory medicine practice guidelines: analytical issues for biochemical markers of acute coronary syndromes. Circulation. 2007;115:e352–e355. https://10.1161/CIRCULATIONAHA.107.182881 - DOI - PubMed
-
- Christenson R.H., Jacobs E., Uettwiller-Geiger D., Estey M.P., Lewandrowski K., Koshy T.I., Kupfer K., Li Y., Wesenberg J.C. Comparison of 13 commercially available cardiac troponin assays in a multicenter North American study. J. Appl. Lab. Med. 2017;2:134. https://10.1373/jalm.2017.023903 - DOI - PubMed
-
- Jarolim P. High sensitivity cardiac troponin assays in the clinical laboratories. Clin. Chem. Lab. Med. 2015;53:635–652. https://10.1515/cclm-2014-0565 - DOI - PubMed
-
- Apple F.S. A new season for cardiac troponin assays: it's time to keep a scorecard. Clin. Chem. 2009;55:1303–1306. https://10.1373/clinchem.2009.128363 - DOI - PubMed
Publication types
LinkOut - more resources
Full Text Sources
Research Materials