ABSTRACT
Objective@#To determine the utility of a highly sensitive troponin assay when utilized in the emergency department. @*Methods@#The FAST-TRAC study prospectively enrolled >1,500 emergency department patients with suspected acute coronary syndrome within 6 hours of symptom onset and 2 hours of emergency department presentation. It has several unique features that are not found in the majority of studies evaluating troponin. These include a very early presenting population in whom prospective data collection of risk score parameters and the physician’s clinical impression of the probability of acute coronary syndrome before any troponin data were available. Furthermore, two gold standard diagnostic definitions were determined by a pair of cardiologists reviewing two separate data sets; one that included all local troponin testing results and a second that excluded troponin testing so that diagnosis was based solely on clinical grounds. By this method, a statistically valid head-to-head comparison of contemporary and high sensitivity troponin testing is obtainable. Finally, because of a significant delay in sample processing, a unique ability to define the molecular stability of various troponin assays is possible.Trial registration ClinicalTrials.gov Identifier NCT00880802
ABSTRACT
Ischemia-modified albumin [IMA'] is a novel marker for assessing cardiac ischaemia. We assessed the relationship between total albumin concentrations and IMA in serum to investigate whether interpretation of IMA was albumin-dependent. 298 serum samples were assayed for total albumin [albumin], using bromcresol purple, and IMA, using an indirect colorimetric assay. Correlations were investigated for the whole data set and for two subgroups, those samples with low albumin [= 34 g/l] and those with albumin within the reference interval. There was a significant [r = -0.888, p < 0.0001] negative correlation between IMA and albumin both over the entire range of albumin concentrations and in the low albumin concentration subgroup [r = -0.85, p < 0.0001]; however, there was less significant correlation in the subgroup with albumin within the reference interval [r = -0.37, p < 0.0001]. A negative correlation exists between IMA and albumin concentrations; however, there is less significant correlation when albumin is within the reference interval. IMA concentrations determined in patients with albumin concentrations = 34 g/l should be interpreted with some caution