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11 protocols using advia centaur tni ultra assay

1

Comprehensive Cardiac Biomarker Evaluation

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Complete blood count parameters were measured with a Coulter STKS electronic counter. Blood samples for CRP and cardiac troponin assessments were drawn in all patients upon admission to the emergency department or at the catheterization laboratory prior to primary PCI. A second sample was drawn following primary PCI, and within 48 h from CICU admission.
The white blood count (WBC) was determined by the Coulter STKS (Beckman Coulter, Nyon, Switzerland) electronic cell analyzer. Wide range C-reactive protein (CRP) levels were determined by the Bayer wr-CRP assay (Bayer, Leverkusen, Germany) [16 (link)]. High-sensitivity cardiac troponin I was measured by an ADVIA Centaur® TnI-Ultra® assay (Siemens, Munich, Germany).
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2

Comparison of cTnI Measurement Methods

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Venous blood samples were collected both in tubes containing ethylendiaminetetraacetic acid (EDTA) and in serum tubes. Samples in EDTA tubes were centrifuged immediately after collection (4°C; 3500g). Serum samples were centrifuged 15‐20 minutes after collection (25°C; 4000g). One serum aliquot was shipped on the day of the blood collection to an external laboratory (IDEXX Laboratories, Ludwigsburg, Germany) for the measurement of the cTnI concentration, using a conventional cTnI assay (Immulite 2000 troponin I test; Siemens Healthcare Diagnostics) with a detection limit of 0.2 ng/mL (measuring range 0.2‐180 ng/mL). Remaining serum and EDTA‐plasma samples were stored in batches at −80°C until being shipped on dry ice to the same external laboratory (IDEXX Laboratories) for the determination of the cTnI concentrations from serum and EDTA‐plasma by the hs‐cTnI assay (Advia Centaur TnI‐Ultra assay; Siemens Healthcare Diagnostics). The hs‐cTnI assay is a second‐generation sandwich immunoassay using 3 different antibodies and direct chemiluminometry. The detection limit of this assay is 0.006 ng/mL (measuring range 0.006‐50 ng/mL). Urea and creatinine concentrations were measured in‐house (Cobas Integra 400 plus; Roche Diagnostics, Rotkreuz, Switzerland).
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3

Biomarker Measurements in Blood and Urine

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Venous blood samples were drawn on the day of examination. Routine blood samples (eg, haemoglobin, creatinine, highly sensitive C reactive peptide [hsCRP]) and urine-albumin were analysed successively. Blood samples for later tests were centrifuged at 4°, and plasma was stored at −80°C. Plasma concentrations of NT-proBNP (ng/L) were measured with the IMMULITE 2000 NT-proBNP, solid-phase, two-site chemiluminescent immunometric assay (Siemens Healthcare Diagnostics).16 (link) Plasma concentrations of mid-regional proadrenomedullin (MR-proADM) (nmol/L) and copeptin (C-terminal provasopressin) (pmol/L) were measured on BRAHMS KRYPTOR with specified automated immunofluorescent assays.17 18 (link) Plasma concentrations of troponin-I were measured with ADVIA Centaur TnI-Ultra assay (Siemens Healthcare Diagnostics).19 (link) Concentrations of urinary albumin were measured in spot-urine. Microalbuminuria was defined as 20–199 mg/L and macroalbuminuria ≥200 mg/L.
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4

Feline Biochemical and Biomarker Analysis

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Blood was collected by cephalic or jugular venipuncture into serum tubes after an overnight fast. Samples were divided into 3 aliquots, frozen at −20°C and shipped the same day to Idexx Bioanalytics, Germany. One aliquot was thawed on the day of arrival for analysis of biochemistry (Beckman Coulter AU58000, Beckman Coulter, Brea CA), total T4 (DRI Thyroxine, Microgenics, Fremont, California), cardiac troponin I (cTnI) (ADVIA Centaur TnI‐Ultra Assay, Siemens Healthineers, Germany), glucose (Immulite 2000/XPi, Siemens Healthineers, Germany), IGF‐1 (CLIA, Siemens, Immulite 2000, Idexx, Germany) and SAA (LAA, Eiken Chemical, Beckman Coulter AU5800, Idexx, Germany). One aliquot was kept frozen at −80°C and shipped on dry ice to the UK for analysis of insulin (IRMA, Beckman Coulter, Nationwide, UK) within approximately 8 days after blood collection. The remaining aliquot was thawed on the day of arrival or frozen at −80°C and thawed within 2 days for analysis of N‐terminal pro B‐type natriuretic peptide (NT‐proBNP) (Feline Cardiopet NT‐proBNP Immunoassay, Idexx, Germany).
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5

Cardiac Biomarkers Measurement Protocol

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Plasma concentrations of cTnI and NT-proBNP were measured by radioimmunoassay (ADVIA Centaur TnI-Ultra Assay, Siemens; IMMULITE 2000 NT-proBNP, Siemens). cTnI was considered positive for values >6 ng/L and significantly elevated at a level >40 ng/L (99th percentile). NT-proBNP was considered positive at a level of >125 pg/ml.
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6

Serum NRG-1β Measurement in Emergency Department

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Each patient's care was guided by the treating physician; the study sample was the first serum sample drawn during the ED visit and subsequently analyzed for troponin I (Siemens ADVIA Centaur® TnI-Ultra assay). These serum samples are typically drawn within hours of arrival in the emergency department for acute care. Plasma samples were collected in EDTA vacutainer tubes at enrollment and stored at −80°C. At the time of analysis, the frozen samples were thawed in a single run. NRG-1β concentration in samples was measured using a DuoSet ELISA Development System from R&D Systems, Minneapolis, MN (cat# DY377), according to manufacturer's specifications at the time of this assay lot and as previously reported [11 (link)]. Subsets of samples were run at dilutions of 1 : 5 and 1 : 30. Concentrations were calculated from the 1 : 5 dilution unless the value was above the highest standard, in which case the 1 : 30 dilution was used. If values from the 1 : 30 dilution remained above the highest standard, they are reported as 314.5 ng/mL. If levels were undetectable, the values were set to the limit of detection defined as 1/2 the value of the lowest point on the standard curve.
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7

Biomarkers Profiling in Disease

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Biomarkers measured in this study at baseline included ST2 (fibrosis); GDF-15 (apoptosis); NT-proBNP (N-terminal pro-B-type natriuretic peptide; myocyte stretch); cTnI (cardiac troponin I; myocardial injury); hsCRP and IL-6 (interleukin-6; inflammation); cystatin C (renal dysfunction); and D-dimer (thrombosis).13 (link)–18 (link) GDF-15, cystatin C, and IL-6 were measured using a Quantikine Human Immunoassay (R&D Systems, Minneapolis, MN). ST2 was measured using the Presage Assay (Critical Diagnostics, San Diego, CA). C-Reactive Protein (CRP) was measured using the CardioPhase High Sensitivity C-Reactive Protein Immunoassay (Siemens Medical Solutions Diagnostics, Tarrytown, NY). Troponin was measured using the Advia Centaur TnI-Ultra Assay (Siemens Medical Solutions Diagnostics). NT-proBNP was measured by the Roche E Modular assay (Roche Diagnostics Corporation, Indianapolis, IN). D-dimer was measured using the Zymutest D-Dimer ELISA (Aniara, West Chester, OH). Details on sensitivity, range, and coefficients of variation have been published previously.2 (link)
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8

Biomarkers of Cardiovascular Disease

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Biomarkers measured in this study at baseline included: ST2 (fibrosis); GDF-15 (apoptosis); NT-proBNP (myocyte stretch); cTnI (myocardial injury); hsCRP and IL-6 (inflammation); Cystatin C (renal dysfunction); and D-dimer (thrombosis).13 (link)-18 (link) GDF-15, Cystatin C, and IL-6 were measured using a Quantikine Human Immunoassay (R&D systems, Minneapolis, MN). ST2 was measured using the Presage Assay (Critical Diagnostics, San Diego, CA). CRP was measured using the CardioPhase High Sensitivity C-Reactive Protein Immunoassay (Siemens Medical Solutions Diagnostics, Tarrytown, NY). Troponin was measured using the Advia Centaur TnI-Ultra Assay (Siemens Medical Solutions Diagnostics, Tarrytown, NY). NT-proBNP was measured by the Roche E Modular assay (Roche Diagnostics Corporation, Indianapolis, IN). D-dimer was measured using the Zymutest D-Dimer ELISA (Aniara, West Chester, Ohio). Details regarding sensitivity, range, and coefficients of variation have been published previously2 (link).
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9

Biomarker Profiling in Hospitalized Patients

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A venous blood sample was obtained within 1 day after hospital admission. The blood samples were centrifuged at 800  g for 5 minutes at 4°C and the serum was obtained. Blood biochemical examination including alanine aminotransferase (ALT), total bilirubin (TBIL), creatinine, creatine kinase (CK)-MB, D-dimer, and N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) were measured in the core laboratories of the hospital. Arterial blood gas analysis was performed within 1  day after admission. High-sensitivity cardiac troponin (hs-cTnI) concentration was assessed by ADVIA Centaur® TnI-Ultra® assay (Siemens Healthcare Diagnostics Inc., Malvern, Pennsylvania, USA) on an ADVIA Centaur XP Immunoassay System (Siemens Healthcare GmbH, Erlangen, Germany).
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10

Biomarkers

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At enrollment (baseline) and at each subsequent Holter visit, 5 mL of venous blood were collected. The samples were centrifuged, plasma (for NT‐proBNP) and serum (for cTnI and CRP) were separated and collected. At 1 center, samples were stored at −20°C for up to 3 weeks before analysis. At the other centers samples were stored at −80°C until the end of the study. The NT‐proBNP was analyzed using the Cardiopet proBNP test (IDEXX Laboratories, 2nd generation ELISA), the cTnI by ultrasensitive chemiluminescence immunoassay (Advia Centaur TnI‐Ultra assay; Siemens Healthcare Diagnostics) and CRP by immunoturbidimetry.
To determine which clinical, echocardiographic or biomarker variables were important to achieving a meanHRHolter <125 bpm, echocardiography was performed, and blood was collected for biomarkers measurement at each Holter visit. Only the echocardiographic and biomarker data from the date of Holterfinal were analyzed.
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