Abstract：
BACKGROUND:Low concentrations of cardiac troponin (cTn) have been recommended for rapid rule-out of acute myocardial infarction (AMI). We examined the Beckman Coulter Access high-sensitivity cardiac troponin I (hs-cTnI) assay to identify a single test threshold that can safely rule out AMI. METHODS:This analysis used stored samples collected in 2 prospective observational studies. In all, 1871 patients presenting to a tertiary emergency department with symptoms of acute coronary syndrome had blood taken for measurement of cTnI on presentation. The endpoint was type 1 myocardial infarction (T1MI). Sensitivity and negative predictive value (NPV) were calculated for hs-cTnI values below the 99th percentile. RESULTS:Ninety-eight patients had T1MI (5.2%), and 638 (34.1%) patients had an hs-cTnI <2 ng/L (limit of detection), with sensitivity of 99.0% (95% CI, 94.4%-100%) and NPV of 99.8% (95% CI, 99.1%-100%). No hs-cTnI value above a concentration of 2 ng/L achieved sensitivity of 99%. However, an NPV of 99.5% was achieved at values <6 ng/L. A cutoff <6 ng/L enabled 1475 (78.8%) patients to be ruled out on presentation with sensitivity of 93.9% (95% CI, 87.1%-97.7%). CONCLUSIONS:A single baseline cTn <2 ng/L measured with the Access hs-cTnI assay performed well for rule-out of AMI. This cutoff concentration identified 99% of patients with AMI and could reduce the number of patients requiring lengthy assessment. A cutoff of <6 ng/L yielded a high NPV but missed more cases of AMI than would be acceptable to clinicians.
journal_name
Clin Chemjournal_title
Clinical chemistryauthors
Greenslade J,Cho E,Van Hise C,Hawkins T,Parsonage W,Ungerer J,Tate J,Pretorius C,Than M,Cullen Ldoi
10.1373/clinchem.2017.283887subject
Has Abstractpub_date
2018-05-01 00:00:00pages
820-829issue
5eissn
0009-9147issn
1530-8561pii
clinchem.2017.283887journal_volume
64pub_type
杂志文章abstract：:We compared results for measurements of creatine kinase isoenzyme MB (CK-MB) by immunoinhibition vs immunoprecipitation, using sera from 53 normal healthy individuals, 55 patients with increased CK-MB associated with acute myocardial infarction, and 42 patients whose blood exhibited one or more abnormal forms of CK by...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1982-10-01 00:00:00
abstract：:The manual Reference Method of the Centers for Disease Control for serum iron (CDC/RM/Fe) and a semiautomated adaptation of it were used to evaluate two working methods: one, a detergent solubilization procedure for the Roche Cobas-Bio analyzer, the other, the Kodak Ektachem 700 procedure, based on dry-film technology...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1990-10-01 00:00:00
abstract：:Cerebrospinal fluid (CSF) from uninfected patients and from patients with bacterial and viral meningitis was analyzed by gas-liquid chromatography, with use of a flame ionization detector, and by gas chromatography-mass spectrometry. The resulting profiles were consistent and reproducible. Hydroxy acids were the compo...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1984-07-01 00:00:00
abstract：BACKGROUND:We evaluated the completeness of reporting of diagnostic test accuracy (DTA) systematic reviews using the recently developed Preferred Reporting Items for Systematic Reviews and MetaAnalyses (PRISMA)-DTA guidelines. METHODS:MEDLINE® was searched for DTA systematic reviews published October 2017 to January 2...
journal_title：Clinical chemistry
pub_type： 杂志文章,meta分析
doi：10.1373/clinchem.2018.292987
更新日期：2019-02-01 00:00:00
abstract：:A plasma protein required for the support of ristocetin-induced platelet aggregation was isolated from antihemophilic factor concentrate and radiolabeled with 125I. A double-antibody radioimmunoassay was developed, with use of specific rabbit anti-VIII related antigen serum and goat anti-rabbit globulin. The assay is ...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1977-09-01 00:00:00
abstract：:A new radiometric assay specific for creatine kinase isoenzyme MB was evaluated with respect to its precision and agreement with a conventional electrophoretic CK-MB assay for the diagnosis of myocardial infarction. The reference interval we find for serum CK-MB in healthy subjects is 0--30 micrograms/L. The coefficie...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1981-06-01 00:00:00
abstract：BACKGROUND:Band 5 tartrate-resistant acid phosphatase (TrACP; EC 3. 1.3.2) consists of two isoenzymes, bands 5a and 5b, of which band 5b TrACP is considered to be derived from bone. However, no kinetic method for the specific measurement of band 5b TrACP in serum is available. Our aim was to develop a kinetic assay met...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：2000-04-01 00:00:00
abstract：:Sensitivity, stability, and specificity of the color-producing reaction of hydrogen peroxide with bezidine, leuco-malachite green, or o-dianisidine were tested in numerous systems containing hemoglobin and other hemoproteins. Use of urea or low temperature (to minus 12 degrees C), or both, was highly beneficial, espec...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1975-03-01 00:00:00
abstract：:We tested the diagnostic sensitivity of various urinary analytes for detecting cadmium-induced nephropathy at an early stage. We investigated 73 healthy persons (control group 1) and individuals exposed to cadmium, either environmentally (n = 36, risk group 2) or occupationally (n = 62, exposed group 3). All data were...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1993-05-01 00:00:00
abstract：:Using the Selected Method of McKenzie and Henderson (Selected Methods Clin Chem 1983;10:59-67) as a reference method, we compared the performance of 10 commercially available methods for determination of lactate dehydrogenase (LD, EC 1.1.1.27) isoenzymes. Results were expressed as percentage of total LD activity, as d...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1988-09-01 00:00:00
abstract：BACKGROUND:Until recently, clinical laboratories have monitored hemophilia treatment by measuring coagulation factors before/after infusion of human-derived or recombinant factors. Substantial changes are expected in the near future based on new therapeutic approaches that have been or are being developed. CONTENT:Hem...
journal_title：Clinical chemistry
pub_type： 杂志文章,评审
doi：10.1373/clinchem.2017.284356
更新日期：2019-02-01 00:00:00
abstract：BACKGROUND:Human herpesvirus 6 (HHV-6) latently infects a majority of adults. In about 1% of the population HHV-6 exists in a chromosomally integrated form (ciHHV-6) that resides in every somatic and germ cell and can be transmitted through the germ line. Patients with ciHHV-6 have been misdiagnosed and unnecessarily t...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：10.1373/clinchem.2013.217240
更新日期：2014-05-01 00:00:00
abstract：:We describe a gas-chromatographic method for measuring chlorpromazine and its metabolites chlorpromazine sulfoxide, mono-N-desmethylchlorpromazine, and di-N-desmethylchlorpromazine at therapeutic concentrations in human serum, with use of a nitrogen detector. The compounds are extracted from serum at pH 10.5 into hexa...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1979-07-01 00:00:00
abstract：:Using a continuous-flow (Technicon SMAC) analyzer, we measured the concentration of 20 analytes in capillary blood sera from 149 neonates in an intensive-care unit. Included were term and pre-term babies, both groups with and without asphyxia. The values obtained, especially for those enzymes and analytes that are rel...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1984-04-01 00:00:00
abstract：:Highly purified human lactate dehydrogenase 1 has been used in an interlaboratory evaluation and improvement progran in clinical chemistry in New York State since 1971. Although there are difficulties in determining and assigning the most nearly accurate values for test samples in the absence of a reference method and...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1977-06-01 00:00:00
abstract：BACKGROUND:HDL is quantitatively the most important lipoprotein in most species and mechanistic evidence points toward a role for HDL in normal immune function. We tested the hypothesis that concentrations of HDL cholesterol are associated with risk of autoimmune disease. METHODS:From 2 studies of the general populati...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：10.1373/clinchem.2018.299636
更新日期：2019-05-01 00:00:00
abstract：:We examined the changes in sensitivity and specificity that would occur with alterations in the sample-collection schedule and (or) cutoff criterion for the increase in hydrogen concentration in breath after administration of doses of lactose in the dietary range. In a breath-analysis test to classify individuals as l...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1983-03-01 00:00:00
abstract：BACKGROUND:A genomic deletion of exon 3 (d3-GHR) of the growth hormone (GH) receptor (GHR) has been linked to the effectiveness of GH therapy in children with GH deficiency. Carriers of the d3-GHR genotype had higher GH-induced growth rates than children homozygous for the full-length (fl)-GHR. The aim of this study wa...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：10.1373/clinchem.2007.085712
更新日期：2007-08-01 00:00:00
abstract：:We assessed several methods of inorganic phosphate assay for their suitability in estimating phospholipids in digested extracts of amniotic fluids. The extraction and digestion procedures used for phospholipids from amniotic fluid were also examined critically. The effect of contamination by blood or obstetric cream h...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1975-09-01 00:00:00
abstract：:Using image-analyzing equipment, we measured the effect of quinidine on the activity of naphthol AS-D chloroacetate esterase, alpha-naphthyl butyrate esterase, alpha-naphthyl acetate esterase, and acid phosphatase in individual cells of a human Hep G2 hepatoma cell line. The impact of the drug on the morphology of the...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1988-03-01 00:00:00
abstract：BACKGROUND:Prediction of cyclosporine (CSA) efficacy and toxicity in individual patients is difficult. There is no practical, biologically relevant, pharmacodynamic measure of CSA effect. A major effect of CSA is to decrease interleukin-2 (IL-2) production; however, measurement of this effect in isolated lymphocytes as...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1999-09-01 00:00:00
abstract：:We developed a simple method for the analysis of bismuth (Bi) in biological tissue, using wet digestion for sample pretreatment. Bi was determined by electrothermal atomic absorption spectrometry with platinum as a matrix modifier to decrease the volatility of Bi. The furnace program included a gas stop for sensitivit...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1993-05-01 00:00:00
abstract：BACKGROUND:Identifying markers of chronic kidney disease (CKD) that occur early in the disease process and are specific to loss of kidney function rather than other underlying causes of disease may allow earlier, more accurate identification of patients who will develop CKD. We therefore sought to identify diagnostic b...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：10.1373/clinchem.2018.291104
更新日期：2019-03-01 00:00:00
abstract：:This procedure for routine quantification of albumin in urine is based on the dye-binding properties of albumin with bromphenol blue. The absorbance of 100 microL of urine mixed with 3 mL of color reagent is measured against blank reagent at 610 nm after 30 s. Results vary linearly with albumin concentration up to 6 g...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1987-02-01 00:00:00
abstract：BACKGROUND:Subfractions of HDL, particularly large HDL (HDL2), are inversely correlated with the severity of coronary artery disease (CAD). alpha-Tocopherol (AT) is the main lipid-soluble antioxidant in plasma. Results of a previous small study (n = 44) suggested that either a combination of an antioxidant cocktail [80...
journal_title：Clinical chemistry
pub_type： 杂志文章,随机对照试验
doi：10.1373/clinchem.2006.078865
更新日期：2007-03-01 00:00:00
abstract：:A new method for the reliable identification of localized variations in DNA by detection of associated diagnostic products with matrix-assisted laser desorption ionization time-of-flight mass spectrometry is described. The diagnostic products are generated by the primer oligo base extension (PROBE) reaction, which req...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1997-07-01 00:00:00
abstract：BACKGROUND:Standardization of hemoglobin (Hb)A(1c) measurements is a process of considerable interest for quality assurance in diabetes management. To contribute to continuous quality improvement and fulfillment of the requirements for reference measurement procedures according to the standards of the International Org...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：10.1373/clinchem.2009.139477
更新日期：2010-05-01 00:00:00
abstract：:I present the general pattern relationship between (a) plasma fibrinogen and cholinesterase activity and (b) plasma fibrinogen and hemoglobin, in 250 and 310 hospitalized adults, respectively. Although responses of cholinesterase were often unrelated to fibrinogen, when its activity in plasma was depressed, above-norm...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1977-01-01 00:00:00
abstract：:Recent evidence indicates that high-density lipoprotein triglyceride (HDL-Tg) may be a predictor of coronary artery disease. We examined three methods for HDL-Tg measurement, comparing results obtained by measurement of Tg in the supernate after heparin-manganese chloride (heparin-Mn) precipitation of EDTA-treated pla...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1988-10-01 00:00:00
abstract：:Detection and characterization of small IgM paraproteins by immunoelectrophoresis are often difficult because of (a) slow diffusion of the macromolecular immunoglobulin, and (b) the obscuring of the light chain, especially kappa, by the light chains of background polyclonal immunoglobulin (the "umbrella effect"). Vari...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1988-08-01 00:00:00
