Abstract：
BACKGROUND:Increasing numbers of patients are presenting worldwide to emergency departments with suspected myocardial infarction. The use of point-of-care troponin assays might enable faster decision-making in this high-risk population and reduce the burden on emergency facilities. Here, we evaluate the diagnostic performance of a point-of-care high-sensitivity troponin I assay. METHODS:We conducted a prospective cohort study including patients presenting to the emergency department with suspected myocardial infarction from July 2013 to July 2016. A diagnostic algorithm for a high-sensitivity troponin I point-of-care assay was developed in a derivation data set with 669 patients and validated in an additional 610 patients. RESULTS:The derived 0/1 h algorithm for the point-of-care assay consisted of an admission troponin I <4 ng/L and a δ from 0 h to 1 h <3 ng/L for rule out and an admission troponin I ≥90 ng/L or a δ from 0 h to 1 h ≥20 ng/L for rule in of non-ST-elevation myocardial infarction. Application to the validation cohort showed a negative predictive value of 99.7% (95% CI, 98.1%-100.0%) and 48.0% of patients ruled out, whereas 14.6% were ruled in with a positive predictive value of 86.5% (95% CI, 77.6%-92.8%). The diagnostic performance of the point-of-care high-sensitivity assay was highly comparable to guideline-recommended use of a laboratory-based high-sensitivity troponin assay. CONCLUSIONS:The clinical application of a 0/1 h diagnostic algorithm based on a high-sensitivity troponin I point-of-care assay is safe, and diagnostic performance is comparable to a laboratory-based high-sensitivity troponin I assay.
journal_name
Clin Chemjournal_title
Clinical chemistryauthors
Sörensen NA,Neumann JT,Ojeda F,Giannitsis E,Spanuth E,Blankenberg S,Westermann D,Zeller Tdoi
10.1373/clinchem.2019.307405subject
Has Abstractpub_date
2019-12-01 00:00:00pages
1592-1601issue
12eissn
0009-9147issn
1530-8561pii
clinchem.2019.307405journal_volume
65pub_type
杂志文章abstract：:We have reported (Clin Chem 29: 42-44, 1983) that prestaining with Remazol Brilliant Blue permits direct visualization of serum components on disc electrophoresis, and apparently purifies the proteins well. Here we have cut out the bands corresponding to the prestained albumin and transferrin after disc electrophoresi...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1984-07-01 00:00:00
abstract：:Histograms of the results of quantitative clinical laboratory analyses are usually broadly skewed because some of the patients have normal values with respect to the analyte being measured while values for others are below or above normal. We describe a technique for calculating the maximum possible number of individu...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1978-04-01 00:00:00
abstract：BACKGROUND:Concentrations of physiological response variables fluctuate over time. The present study describes within-day and seasonal fluctuations for total cholesterol, dehydroepiandrosterone sulfate (DHEA-S), hemoglobin A(1c) (HbA(1c)), IgA, prolactin, and free testosterone in blood, and estimates within- (CV(i)) an...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：2000-04-01 00:00:00
abstract：BACKGROUND:High-sensitivity C-reactive protein (hsCRP) testing is relatively inexpensive and has been shown to predict the risk of cardiovascular disease (CVD) and diabetes in multiple patient groups, including those treated with statin therapy. JUPITER (Justification for the Use of Statins in Primary Prevention: An In...
journal_title：Clinical chemistry
pub_type： 杂志文章,评审
doi：10.1373/clinchem.2008.109728
更新日期：2009-02-01 00:00:00
abstract：:Using a high-affinity solid-phase-bound antibody (Ka = 1.2 X 10(11) L/mol), we have standardized a two-step radioimmunoassay for free triiodothyronine (FT3) in serum, based on immunoextraction. The method was validated by comparison with an equilibrium-dialysis procedure (r = 0.96) involving RIA of T3 in the dialysate...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1987-03-01 00:00:00
abstract：:We evaluated the enzymic mechanism by which 3-keto butylidene-beta-2-chloro-4-nitrophenyl maltopentaoside (3KB-G5-CNP) serves as a substrate for serum pancreatic (p-) and salivary (s-) amylases. In aliquots of the reaction mixture, three kinds of beta-2-chloro-4-nitrophenyl oligosaccharides (glucose, maltoside, and ma...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1991-08-01 00:00:00
abstract：:We adapted the method of McCaman and Robins for fluorometry of phenylalanine to a microplate assay for routine phenylketonuria screening. Sensitivity is 15 mumol/L for the plasma assay and 30 mumol/L for the dried blood-spot assay, with CV less than 10% for both assays. Results for human plasma by microplate assay cor...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1989-10-01 00:00:00
abstract：:We have modified the 63Ni radiochemical method of Ho (Anal Biochem 1970;36:105) for determination of free fatty acids (FFA) in plasma. Extracting 1 or 0.1 mL of plasma with Dole's mixture (J Biol Chem 1960;235:2595) and washing the "heptane" layer with two volumes of isopropanol/water/dilute (0.5 mol/L) H2SO4 (25/25/1...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1987-01-01 00:00:00
abstract：BACKGROUND:Studies of the effects of tobacco smoke often rely on reported exposure to cigarette smoke, a measure that is subject to bias. We describe here the relationship between parental smoking exposure as assessed by urinary cotinine excretion and lung function in children with asthma. METHODS:We studied 90 childr...
journal_title：Clinical chemistry
pub_type： 临床试验,杂志文章
doi：
更新日期：1999-04-01 00:00:00
abstract：:We adapted an inhibition assay for methotrexate, involving dihydrofolate reductase from bovine liver, for use with a discrete analyzer (the ABA-100). The analyzer was used both for dilution and a 5-min pre-incubation of the sample with NADPH--enzyme reagent, and for the assay itself. The standard curve was linear betw...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1980-02-01 00:00:00
abstract：:To determine the molar absorptivities of beta-NADH and beta-NAD at 260 nm, we purified the reduced form of the coenzyme by repeated anion-exchange chromatography. A NADH preparation was so obtained for which the 260 nm/340 nm absorbance ratio was 2.265. When calculated with epsilon 340 beta-NADH = 6.22 times 10-3 for ...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1975-06-01 00:00:00
abstract：:The difference in absorbance (delta A) between equimolar acid and alkaline solutions of methyl red, at a wavelength near the isosbestic point of the indicator, is reproducible. Furthermore, this delta A is sensitive to changes in the wavelength calibration of the instrument used to make the measurement. The delta A of...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1986-01-01 00:00:00
abstract：BACKGROUND:First introduced in 2006, recombinase polymerase amplification (RPA) has stirred great interest, as evidenced by 75 publications as of October 2015, with 56 of them just in the last 2 years. The widespread adoption of this isothermal molecular tool in many diagnostic fields represents an affordable (approxim...
journal_title：Clinical chemistry
pub_type： 杂志文章,评审
doi：10.1373/clinchem.2015.245829
更新日期：2016-07-01 00:00:00
abstract：:We report a procedure for determining fecal long-chain fatty acids (LCFA), triglycerides, and cholesterol after detergent extraction with 10 mL/L Triton X-100, 6 mL/L Brij 30, and 0.1 mol/L HCl in isotonic saline by enzymatic analysis of the extraction supernates. Mean recoveries of calibrators ranged from 105% to 117...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1994-12-01 00:00:00
abstract：:An oligonucleotide "melting" procedure was developed whereby we can monitor for a sequence heterogeneity in the gene for apolipoprotein E production. Two oligonucleotides were synthesized, one recognizing the common epsilon 3 allele but not the common epsilon 2 allele, the other recognizing the epsilon 2 allele but no...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1986-07-01 00:00:00
abstract：:alpha 1-Antitrypsin (A1AT) deficiency is a relatively common autosomal recessive disease, resulting most often from a single base pair (1 bp) substitution called the Z mutation. Previous genetic tests for carriers and affected patients have relied on quantitative binding of radioactive probes to an amplified gene prod...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1992-08-01 00:00:00
abstract：:We describe an enzymatic fluorometric method for determining glucose concentrations in blood samples by analysis on a semi-solid surface (silicone-rubber pads). The method is an adaptation of existing spectrophotometric procedures based on the sequential coupling reactions with glucose-6-phosphate dehydrogenase and NA...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1975-11-01 00:00:00
abstract：BACKGROUND:Advances in the biological sciences and technology are providing molecular targets for diagnosing and treating cancer. Current classifications in surgical pathology for staging malignancies are based primarily on anatomic features (e.g., tumor-node-metastasis) and histopathology (e.g., grade). Microarrays to...
journal_title：Clinical chemistry
pub_type： 杂志文章,评审
doi：
更新日期：2002-08-01 00:00:00
abstract：:The diagnosis of thyroid disease now often can be achieved reliably by measuring thyrotropin (TSH) alone. Thyroxine (T4), triiodothyronine, and other analytes are only needed if TSH and the accompanying clinical condition are discordant. We describe here work that confirms the age independence of TSH in both inpatient...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1997-11-01 00:00:00
abstract：:Two families with benign hyperphosphatasemia of intestinal origin were studied and compared with six other cases reported in the literature. No evidence of clinical abnormalities or explanations for the unusual enzyme concentrations were found. Agarose gel electrophoresis of alkaline phosphatase (ALP, EC 3.1.3.1) isoe...
journal_title：Clinical chemistry
pub_type： 杂志文章,评审
doi：
更新日期：1991-08-01 00:00:00
abstract：:We review the present knowledge of telomeres and telomerase with special attention to their role in cell proliferation, cellular senescence, and human aging. We summarize the functional aspects of telomerase in cancer, as well as its role as a useful diagnostic and prognostic tumor marker, and discuss possible approac...
journal_title：Clinical chemistry
pub_type： 杂志文章,评审
doi：
更新日期：1997-05-01 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：:Ornithine carbamoyltransferase (EC 2.1.3.3) activity is a sensitive, specific indicator of hepatocellular injury. This paper describes development of an improved automated procedure for measurement of this activity. Triethanolamine-ethylenediaminetetraacetate is used as a buffer, and activity is determined by measurin...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1975-05-01 00:00:00
abstract：BACKGROUND:We investigated agreement between self-reported prenatal alcohol exposure (PAE) and objective meconium alcohol markers to determine the optimal meconium marker and threshold for identifying PAE. METHODS:Meconium fatty acid ethyl esters (FAEE), ethyl glucuronide (EtG), and ethyl sulfate (EtS) were quantified...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：10.1373/clinchem.2014.233718
更新日期：2015-03-01 00:00:00
abstract：:Five genetic defects have been established as risk factors for venous thrombosis. Three are protein C, protein S, and antithrombin deficiencies, defects in the anticoagulant pathways of blood coagulation. Together they can be found in approximately 15% of families with inherited thrombophilia. Their laboratory diagnos...
journal_title：Clinical chemistry
pub_type： 杂志文章,评审
doi：
更新日期：1997-09-01 00:00:00
abstract：:The method is based on the selective activating capacity of dithiothreitol on creatine kinase isoenzyme MB, after isoenzyme MM is activated by glutathione. Isolated isoenzymes MM and MB of human and canine origin were assayed individually and in mixtures of known activities. When glutathione was present in the assay m...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1975-10-01 00:00:00
abstract：:Gene mutations responsible for the majority of Duchenne/Becker muscular dystrophy (DMD/BMD) and cystic fibrosis (CF) chromosomes have been identified. We describe a DNA-based strategy, rather than the traditional biochemical assays, for screening newborns. DNA sequences spanning the CF mutation and several DMD/BMD del...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1990-10-01 00:00:00
abstract：:We evaluated a new agarose-gel-electrophoretic procedure (Corning) (I) for separating and quantitating of high-density lipoprotein cholesterol (HDLC), comparing it with the modified Lipid Research Clinics (LRC) procedure (heparin 183 kilounits/L, MnCl2 92 mmol/L) (II). Method I was insensitive to an HDLC concentration...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1979-11-01 00:00:00
abstract：:Lyophilized serum specimens were manufactured in such a way that fixed quantitative interspecimen relationships were established. The specimens were analyzed for about twenty constituents by several thousand laboratories in 1971, 1972, and 1973. Most of the consensus mean values derived from these analyses were found ...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1976-07-01 00:00:00
abstract：:We evaluated plasma selenium concentrations in patients with euthyroid sick syndrome express by low serum triiodothyronine (T3) concentrations. Selenium status in these patients was compared with that found in patients with both untreated and treated hypothyroidism. Selenium concentrations in plasma were significantly...
journal_title：Clinical chemistry
pub_type： 杂志文章
doi：
更新日期：1992-09-01 00:00:00
