Serum and plasma as alternative sample types in analysis of cardiac markers in the clinical routine

Area of Science:

• Clinical Chemistry
• Biomarker Analysis
• Emergency Medicine Diagnostics

Background:

• Rapid diagnosis of acute chest pain relies on timely cardiac marker results.
• Current reliance on serum samples can lead to extended laboratory turnaround times.
• Optimizing sample types is essential for improving diagnostic efficiency.

Purpose of the Study:

• To investigate the feasibility of using plasma (EDTA- or heparin-plasma) as an alternative to serum for cardiac marker analysis.
• To evaluate the impact of plasma use on assay performance across different analytical systems.
• To determine methods for reducing turnaround time in cardiac marker testing.

Main Methods:

• Quantitative analysis of cardiac markers (troponin I/T, CK-MB mass, myoglobin) using four different analytical systems.
• Comparison of results obtained from serum, EDTA-plasma, and heparin-plasma samples.
• Study population included 391 patients presenting with acute chest pain.

Main Results:

• Heparin-plasma is suitable for troponin, CK-MB mass, and myoglobin assays on Access and Immulite systems.
• EDTA-plasma is suitable for these assays on Access and Elecsys systems.
• Serum remains the preferred sample type for the AxSYM system.

Conclusions:

• Utilizing EDTA- or heparin-plasma with Access, Elecsys, and Immulite analysers can shorten diagnostic turnaround times.
• Plasma-based testing allows for quantitative cardiac marker analysis as quickly as 30 minutes post-sample collection.
• This approach enhances the promptness of critical diagnostic information for patients with acute chest pain.