Poster Abstracts – EuroMedLab Paris 2015 – Paris, 21-25 June 2015 • DOI 10.1515/cclm-2015-5012 Clin Chem Lab Med 2015; 53, Special Suppl, pp S1 – S1450, June 2015 • Copyright © by Walter de Gruyter • Berlin • Boston

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Cardiac markers M282 INTRODUCTION OF HIGH SENSITIVITY TROPONIN T ASSAY IN AN ACUTE HOSPITAL SETTING (1) I. Ramasamy1 Department of Biochemistry, Worcester Royal Hospital, Worcester

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BACKGROUND-AIM New high sensitivity cardiac troponin (hsTnT) assays which can measure the 99th percentile of the normal reference population are being introduced. Lowering the diagnostic threshold may be beneficial but will increase the classification of myocardial infarction and provide additional challenges in the interpretation of results. Our study is unusual in that we investigated the impact of the introduction of the hsTnT assay (Roche diagnostics, UK) in a nonUniversity hospital ie in an unselected cohort of patients presenting with chest pain. METHODS The distribution of hscTnT was determined within 205 community patients, not being investigated for acute coronary syndrome. Two hundred consecutive patients admitted with suspected acute coronary syndrome were stratified by the hsTnT assay into 4 groups: ≤5 ng/ (n= 63),>5 to ≤14 ng/L (n=39), >14 to ≤60 ng/L (n= 59), >60 ng/L (n= 39). HsTnT was measured at 8-12 h following admission. Clinical characteristics, cardiovascular risk factors, drugs on admission, TIMI risk scores, ECG, and management during admission was assessed. The diagnosis was made by clinicians blinded to the results hscTnT values 14 to ≤60 ng/L were diagnosed with noncardiac causes, 19% with angina but with a cut-off value of 60 ng/L, were less likely to be referred for further cardiac assessment or treatment for acute coronary syndrome. CONCLUSION A hsTnT value in the range >14 to ≤60 ng/L was not in itself diagnostic of dynamic cardiac damage and clinical decisions may depend on serial measurements. In an unselected group of patients, lowering the threshold for hsTnT can potentially identify 19% of patients with hsTnT values >14 to ≤60 ng/L who would be referred for further cardiac assessment.

Unauthenticated Download Date | 1/25/17 4:26 AM

Poster Abstracts – EuroMedLab Paris 2015 – Paris, 21-25 June 2015 • DOI 10.1515/cclm-2015-5012 Clin Chem Lab Med 2015; 53, Special Suppl, pp S1 – S1450, June 2015 • Copyright © by Walter de Gruyter • Berlin • Boston

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Cardiac markers M283 ASSOCIATION OF CARDIOVASCULAR RISK FACTORS WITH TESTOSTERONE DEFICIENCY M. Kelesoglu3, M.I. Mutaf1, B. Burcu1, G. Basol1, B. Semerci4, F. Sarac2 1 Ege University Faculty of Medicine Department Of Clinical Biochemistry 2 Ege University Faculty of Medicine, Department of Internal Medicine 3 Ege University Faculty of Medicine, Department of Medical Biochemistry 4 Ege University Faculty of Medicine, Department of Urology BACKGROUND-AIM Testosterone deficiency is highly prevalent in men with cardiovascular disease and is reported to accelerate atherosclerotic process by increasing oxidative stress, pro-inflammatory factors via affecting the lipid profile and inducing endothelial dysfunction. Lipoprotein associated Phospholipase A2 (Lp-PLA2) which is believed to play a role in atherosclerotic inflammatory process due to its function in hydrolysis of phospholipids and release of proinflammatory products, is considered as a novel biomarker for cardiovascular risk. In this study we aimed to investigate the alterations in Lp-PLA2 and other cardiovascular risk factors in patients with testosterone deficiency. METHODS 40 patients with primary/secondary hypogonadism (group 1) and 30 healthy males (group 2) were enrolled in this study. Serum glucose, albumin, apolipoprotein-B, total cholesterol, HDL-cholesterol, LDL-cholesterol, triglyceride, hsCRP, total testosterone, free testosterone, sex hormone binding globulin (SHBG), Lp-PLA2, small-dense LDL, oxidized LDL and paraoxanase-1 were measured. Bioavailable testosterone was calculated by using total testosterone, SHBG and albumin levels. RESULTS Mean age ± SD was 34.15 ± 6.38 for group 1 and 35.23 ± 7.88 for group 2. Total testosterone, free testosterone, SHBG, bioavailable testosterone and paraoxanase-1 were significantly lower in group 1 (p 0.05 µg/L). ECG did not show any abnormalities. Relaying on laboratory results for cTNi and considering patient’s medical history, physicians decided to proceed an emergency coronary angiography. In the next days, cTNi remains high without a significant kinetic and did not correlate with the patient clinic. A false positive was suspected so cTNi was tested in the patient samples with another system (Vidas ®,Biomérieux) and results were negative. A reagent vigilance procedure was launched after which a large amount of heterophilic antibodies was found in all samples. CONCLUSION Even if the analytical performances of immunoassays were largely improved, heterophilic antibodies interference still occurs and may be underestimated. A perfect knowledge of our method in the laboratory and a good cooperation between clinical chemists and physicians remain indispensable to improve patient management. In our case, false positive leaded to an unnecessary coronary angiography to a 70 year old man.

Unauthenticated Download Date | 1/25/17 4:26 AM

Poster Abstracts – EuroMedLab Paris 2015 – Paris, 21-25 June 2015 • DOI 10.1515/cclm-2015-5012 Clin Chem Lab Med 2015; 53, Special Suppl, pp S1 – S1450, June 2015 • Copyright © by Walter de Gruyter • Berlin • Boston

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Cardiac markers M301 PREDICTION VALUE OF INFLAMMATORY MARKERS IN PATIENTS WITH CORONARY HEART DISEASE J. Pawlus1, M. Rusak1, M. Dabrowska1 1 Medical University of Bialystok, Poland BACKGROUND-AIM It has been reported that inflammation plays an important role in the pathogenesis of atherosclerosis, and increased level of inflammatory markers in patients with coronary heart disease (CHD) has been reported. However, there is no data about early markers of CHD progression. The aim of this study was evaluate a prediction value of serum myeloperoxidase (MPO), the absolute number of neutrophils (NEUT), fibrinogen (FIB) and C-reactive protein (CRP) level for CHD progression in patients with stable angina (SA), unstable angina (UA) and acute myocardial infarction (MI). METHODS The study has included 129 patients with CHD and 25 healthy volunteers. Serum MPO level was measured by ELISA immunoenzymatic assay; the NEUT was determined by optical method based on the peroxidase activity (Advia); FIB concentration was measured by Clauss method; CRP concentration was determined by immunoturbidimetric method. RESULTS Results have shown statistically significant increase of MPO concentration (ng/ml) along with the progression of CHD from SA to MI (control 2,48±0,59; SA 3,15±1,13; UA 4,2±1,3; MI 6,09±2,89). Moreover, the percentage of patients with MPO level above the preclusion value (>3,1ng/ml) was significant higher in all tested groups compared to troponine I (TnI) and CK-MB (SA 48% vs. 8% and 30%; UA 87% vs. 13% and 34%; MI 91% vs. 83% and 47% respectively). No significant differences were found in NEUT and serum CRP level, between healthy subjects (Control) and patients with CHD. The highest level of FIB (mg/dl) has been observed in the group with MI, and this increase was significantly higher compared with UA and SA groups (MI 522,38±134,51; UA 418,48±52,93 SA 413,51±55,83). MPO shows the highest diagnostic sensitivity in differentiation of UA vs. Control and MI vs. Control (AUC: 0,924; AUC: 0,941 respectively) as well as the highest sensitivity in differentiation of SA vs. UA, SA vs. MI, UA vs. MI (AUC: 0,753; AUC: 0,860; AUC: 0,745 respectively) CONCLUSION The MPO is more sensitive indicator of inflammation associated with atherosclerotic plaque than the CRP, NEUT, and FIB. It may suggest that MPO participates in plaque vulnerability and in the process of plaque destabilization. Elevated serum MPO may serve as attractive marker of CHD unfavorable progression especially with low TnI levels.

Unauthenticated Download Date | 1/25/17 4:26 AM

Poster Abstracts – EuroMedLab Paris 2015 – Paris, 21-25 June 2015 • DOI 10.1515/cclm-2015-5012 Clin Chem Lab Med 2015; 53, Special Suppl, pp S1 – S1450, June 2015 • Copyright © by Walter de Gruyter • Berlin • Boston

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Cardiac markers M302 ANALYTICAL EVALUATION AND REFERENCE RANGE OF AN IMMUNOTURBIDIMETRIC HEART-TYPE FATTY ACIDBINDING PROTEIN ASSAY A. Dimitrova-karamfilova1, N. Hristova1, G. Natchev2, T. Pencheva1, I. Petrova1 1 Clinical laboratory, UH “St. Ekaterina”, Sofia, Bulgaria 2 Department of cardiac surgery, UH “St. Ekaterina”, Sofia, Bulgaria BACKGROUND-AIM Fatty acid-binding proteins (FABP) are relatively small cytoplasmic proteins (12–15 KDa) that are abundant in tissues with active fatty acid metabolism, including the heart. H-FABP has been found to appear in the circulation superior to that of cardiac troponins in the early hours of acute coronary syndrome and may be a potential marker for early diagnosis. METHODS We evaluated the analytical characteristics of the immunoturbidimetric H-FABP assay (Randox Laboratories Ltd, Crumlin, UK) on the Architect ci 4100 analyzer. The assay employs latex particles coated with mouse monoclonal antiH-FABP antibodies to generate turbidity measured as an absorbance change at 700 nm. To determine the reference range were analyzed 110 control subjects (53 men and 57 women) with no evidence of current acute coronary syndrome, kidney disease, pulmonary embolism aged on average 44.87 years (21 to 81). RESULTS Precision was typically