Dear Mailbase,
I have some concerns about our current protocol for handling of cardiac troponin T (cTnT) results in the presence of haemolysis which I would gratefully hear your views on.
We use Roche Cobas 8000 instruments. The H index for cTnT with our method is 62 umol/L and the interference observed, as a result, is negative. We do not report haemolysed troponin results instead the result is released as ‘Haemolysed’.
However, we have always had a policy in place that if a cTnT result is ‘haemolysed’ that the result should be looked at. If the result on the analyser/middleware is seen to be ‘high’, the requestor is notified that the sample is haemolysed, an urgent repeat sample is requested and an indication given that the cTnT result may be high.
I have been questioning the appropriateness of this protocol as I am having difficulty defining what high is. Is it anything >14 ng/L, the 99th percentile, or is it upward of 100 ng/L, our local critical cTnT result for phoning? Our policy on this is open to interpretation.
We currently don’t consider timed or paired samples (delta changes)? or false negatives, i.e. those troponin results just below 14 ng/L, maybe we should be more concerned about these?
Any and all comments would be appreciated.
Thank you for taking the time to read.
With best wishes,
Janice
Janice Reeve Ph.D., FRCPath
Principal Clinical Biochemist
Department of Clinical Chemistry
St. Vincent's University Hospital
Dublin, Ireland
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