Variability and Error in Cardiac Troponin Testing
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OBJECTIVES: To provide a comprehensive overview of the complexities associated with cardiac troponin (cTn) testing. An emphasis is placed on the sources of error, organized into the preanalytical, analytical, and postanalytical phases of the testing pathway. Controversial areas are also explored. METHODS: A case scenario and review of the relevant literature describing laboratory considerations involving cTn testing are described. RESULTS: Advanced comprehension of the specific assay used in a given laboratory is necessary for optimal reporting, utilization, and quality monitoring of cTn. CONCLUSIONS: cTn assays are reliable diagnostic tests for acute myocardial infarction, but understanding their limitations is required for appropriate result interpretation.
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The NP-Pep is capable of reproducibly and effectively enriching cTnI across all tested serum samples without the use of antibody.
“These serum cTnI enrichment results illustrate the major benefits of functionalized NPs compared to current antibody-based approaches: (1) NPs are capable of reproducibly and effectively enriching cTnI (Supplementary Fig. 23) across all tested serum samples without the use of antibody, thus overcoming the intrinsic antibody-related limitations (vide supra)14,15,51–53.”
From Nanoproteomics enables proteoform-resolved analysis of low-abundance proteins in human serum (2020) · cites this paper as [53]
The functionalized NPs possess unique advantages over antibody-based platforms: comparable size and diffusion kinetics to proteins, high surface area per volume and high number of flexible binding sites, and inexpensive, simple, fast, scalable synthesis with minimal batch-to-batch variability.
“These results highlight the unique advantages that these functionalized NPs possess for protein enrichment over antibody-based platforms: (a) comparable size and diffusion kinetics to proteins, promoting effective capture of low-abundance proteins within complex mixtures20,47,48; (b) high surface area per volume and high number of flexible binding sites, contributing to high ligand density and”
From Nanoproteomics enables proteoform-resolved analysis of low-abundance proteins in human serum (2020) · cites this paper as [53]
These NPs can serve as replacements to conventional immuno-based techniques to overcome antibody-related limitations in cTnI immunoassays and potentially address the current reproducibility crisis caused by antibodies in general.
“Thus, these NPs can serve as replacements to conventional immuno-based techniques to overcome the antibody-related limitations in cTnI immunoassays and potentially address the current reproducibility crisis caused by antibodies in general14–16,51,53.”
From Nanoproteomics enables proteoform-resolved analysis of low-abundance proteins in human serum (2020) · cites this paper as [53]
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- Authors
- Herman, D. S., Kavsak, P. A., & Greene, D. N.
- Affiliations
- University of Pennsylvania (US)
- McMaster University (CA)
- University of Washington (US)
- Corresponding author
- Greene, Dina N
- Venue
- American Journal of Clinical Pathology
- Publisher
- Oxford University Press (OUP)
- Published
- 2017-09-12
- Volume
- 148
- Issue
- 4
- Pages
- 281-295
- ISSN
- 0002-9173 (ISSN-L)
- 1943-7722
- OpenAlex
- W2754045762
- Cited by
- 87
- References
- 128
- Citations by year
- 2026: 9 · 2025: 8 · 2024: 8 · 2023: 4 · 2022: 9 · 2021: 9 · 2020: 17 · 2019: 18 · 2018: 5
- FWCI
- 8.44
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- American Journal of Clinical Pathology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Scientific Measurement and Uncertainty Evaluation
- Keywords
- cardiac troponin, pre-analytical errors, analytical error, acute myocardial infarction diagnosis
- MeSH terms
- Aged, Blood Specimen Collection, Female, Hematologic Tests, Humans, Myocardial Infarction, Pathology, Clinical, Biomarkers, Troponin T
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