Influence of hemolysis on troponin testing: studies on Beckman Coulter UniCel Dxl 800 Accu-TnI and overview of the literature

Abstract

AbstractHemolyzed specimens are the leading pre-analytical problem in the laboratory practice, and exert a negative impact on test results. We assessed the reliability of Beckman Coulter UniCel Dxl 800 Accu-TnI testing on hemolyzed specimens.Twelve non-hemolyzed KAs compared with aliquot #A (HI: 0), a progressive increase of hemolysis occurred in aliquots #B (HI: 25) and #C (HI: 45). The concentration of Accu-TnI gradually decreased from aliquots #A (0.89 μg/L, 0.20–20.16 μg/L), to aliquots #B (0.81 μg/L, 95% CI 0.17–18.37 μg/L; p=0.041) and #C (0.78 μg/L, 95% CI 0.15–17.48 μg/L; p=0.026). In 0/12 (aliquots #B) and 3/12 cases (aliquots #C) the percent decrease exceeded 20% variation. The values remained unchanged in nine samples with Accu-TnI <0.04 μg/L.Accu-TnI values decrease in hemolyzed samples, but the bias might not be clinically significant in samples with hemoglobin <14.5 g/L.