A folding affinity paper-based electrochemical impedance device for cardiovascular risk assessment

A novel affinity paper-based electrochemical impedance device (PEID) was first fully developed for cardiovascular risk assessment. Herein, a simple folding PEID comprising a dual screen-printed electrode was fabricated for label-free electrochemical impedance detection. The results demonstrated in a step-wise manner that the phosphocholine-modified screen-printed carbon electrodes were highly responsive to the clinically required range of C-reactive protein (CRP) (0.005 - 500 mg L^-1; r² = 0.993) levels with a detection limit (3σ/slope) of 0.001 mg L^-1. The optimal binding frequency of CRP-phosphocholine interaction was determined to be 100 Hz. These results implied that our proposed system could be used for simultaneously measuring the CRP levels using a single PEID platform in combination with the specific recognition elements. When assaying two levels of CRP, the overall assay reproducibility for each concentration, expressed as relative standard error of the mean (RSE%; n = 30), was 1.21%. The variation in the measurements between individual electrodes, expressed as the relative standard deviation (RSD), was 2.82%. Using 2 measurement sites per device, the proposed sensor provided excellent precision for the simultaneous detection of CRP. Moreover, the RSD for the CRP levels measured on ten independently fabricated paper-based sheets was 2.11%, thereby offering an acceptable fabrication reproducibility. The presented folding PEIDs were used forthe determination of CRP in patient-derived blood samples with minimised bias and excellent correlation with a standard method (n = 15; CUSUM linearity test, p > 0.10), thus permitting the potential application of PEID for assessing cardiovascular risk in individuals.