Citations 2
Considerations and pragmatic strategies for implementation of point of care testing for high sensitivity cardiac troponin into the acute care setting
Collinson, Paul, Christenson, Robert, Jafri, Lena , Jaffe, Allan S., Apple, Fred S. , Hammarsten, Ola , Omland, Torbjørn, Sandoval, Yader, Mills, Nicholas L., Buchan, Vanessa, Sandberg, Sverre , Aakre, Kristin M., Aakre, Kristin M , Collinson, Paul , Lam, Leo , Pickering, John W. , Christenson, Robert H. , Hoovels, Lieve Van , Cullen, Louise , Jaffe, Allan S. , Omland, Torbjørn , Sandoval, Yader , Mills, Nicholas L , Than, Martin , Aakre, Kristin M.
Clinical Chemistry and Laboratory Medicine (CCLM) | March 5, 2026 | Volume: 64 | Issue: 7 | Pages: 1467-1478
Abstract A challenge in the implementation of rapid risk-stratification algorithms for patients with suspected acute coronary syndrome is the turnaround time for cardiac troponin (cTn) from blood sampling to reporting of results. Measurement of cTn in whole blood using point of care (POC) offers a solution. There is lack of consensus on how these instruments should be assessed and deployed when implemented into routine practice. A pragmatic strategy is needed to balance the requirement for appropriate evaluation, validation and local verification of POC high sensitivity (hs) cTn assays whilst avoiding unnecessary duplication of previously conducted work using central laboratory assays. The International Federation of Clinical Chemistry and Laboratory Medicine Committee on Clinical Application of Cardiac Bio-Markers (IFCC C-CB) has developed an educational document to provide practical suggestions as to how hs-cTn POC assays may be implemented in acute health care settings and networks. The objective of this document is to provide a pragmatic framework for implementation of such systems. The article describes the validation and verification procedures and outlines what should be the responsibility of the manufacturers and provides recommendations on how a local verification may be undertaken before instruments are implemented into routine clinical practice.
Antibody-mediated interferences affecting cardiac troponin assays: recommendations from the IFCC Committee on Clinical Applications of Cardiac Biomarkers
Hammarsten, Ola , Warner, Janet , Lam, Leo , Kavsak, Peter A. , Aakre, Kristin M. , Collinson, Paul , Jaffe, Allan S. , Saenger, Amy K., Mills, Nicholas L. , Omland, Torbjørn , Ordóñez‐Llanos, Jordi , Apple, Fred S. , Aakre, Kristin M , Collinson, Paul O , Mills, Nicholas L , Lindahl, Bertil , Jaffe, Allan S. , Body, Richard
Clinical Chemistry and Laboratory Medicine (CCLM) | March 23, 2023 | Volume: 61 | Issue: 8 | Pages: 1411-1419
Abstract The International Federation of Clinical Chemistry Committee on Clinical Applications of Cardiac Biomarkers (IFCC C-CB) provides educational documents to facilitate the interpretation and use of cardiac biomarkers in clinical laboratories and practice. Our aim is to improve the understanding of certain key analytical and clinical aspects of cardiac biomarkers and how these may interplay. Measurements of cardiac troponin (cTn) have a prominent place in the clinical work-up of patients with suspected acute coronary syndrome. It is therefore important that clinical laboratories know how to recognize and assess analytical issues. Two emerging analytical issues resulting in falsely high cTn concentrations, often several fold higher than the upper reference limit (URL), are antibody-mediated assay interference due to long-lived cTn-antibody complexes, called macrotroponin, and crosslinking antibodies that are frequently referred to as heterophilic antibodies. We provide an overview of antibody-mediated cTn assay interference and provide recommendations on how to confirm the interference and interpret the results.