Susceptibility of cardiac troponin assays to biotin interference

Ithiel J. Frame, Parag Joshi, Caroline Mwangi, Ian Gunsolus, James A de Lemos, Sandeep R Das, Ravindra Sarode, Jyoti P Balani, Fred S. Apple, Alagarraju Muthukumar

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives To investigate biotin interference on three cardiac troponin (cTn) assays and demonstrate a method to overcome biotin interference. Methods cTn levels were measured in (1) plasma from healthy volunteers on 10-mg daily biotin supplementation mixed with a plasma with known elevated troponin, (2) plasmas with known elevated cTn after mixing in reagent biotin to simulate supplementation, and (3) biotin-spiked plasma specimens pretreated with streptavidin-agarose beads. Results Daily biotin ingestion (10 mg) and studies simulating daily biotin use resulted in significant interference in the Gen5 cardiac troponin T (cTnT) assay; the contemporary Gen 4 cTnT and high-sensitivity cardiac troponin I (hs-cTnI) assays were unaffected. The biotin interference threshold was 31, 315, and more than 2,000 ng/mL for Gen5 cTnT, cTnT, and hs-cTnI assays, respectively. Streptavidin pretreatment blocked biotin interference in cTn assays. Conclusions Biotin interference is possible at plasma concentrations achievable by ingestion of over-the-counter supplements that may lead to delayed or missed diagnosis of myocardial injury with the Gen5 cTnT assay.

Original languageEnglish (US)
Pages (from-to)486-493
Number of pages8
JournalAmerican Journal of Clinical Pathology
Volume151
Issue number5
DOIs
StatePublished - Apr 2 2019

Fingerprint

Troponin
Biotin
Troponin T
Troponin I
Eating
Streptavidin
Healthy Volunteers

Keywords

  • Biotin
  • Interference
  • Myocardial infarction
  • Troponin

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

Cite this

Susceptibility of cardiac troponin assays to biotin interference. / Frame, Ithiel J.; Joshi, Parag; Mwangi, Caroline; Gunsolus, Ian; de Lemos, James A; Das, Sandeep R; Sarode, Ravindra; Balani, Jyoti P; Apple, Fred S.; Muthukumar, Alagarraju.

In: American Journal of Clinical Pathology, Vol. 151, No. 5, 02.04.2019, p. 486-493.

Research output: Contribution to journalArticle

@article{adae3cd65bc64e8cbfe64f84d16e22de,
title = "Susceptibility of cardiac troponin assays to biotin interference",
abstract = "Objectives To investigate biotin interference on three cardiac troponin (cTn) assays and demonstrate a method to overcome biotin interference. Methods cTn levels were measured in (1) plasma from healthy volunteers on 10-mg daily biotin supplementation mixed with a plasma with known elevated troponin, (2) plasmas with known elevated cTn after mixing in reagent biotin to simulate supplementation, and (3) biotin-spiked plasma specimens pretreated with streptavidin-agarose beads. Results Daily biotin ingestion (10 mg) and studies simulating daily biotin use resulted in significant interference in the Gen5 cardiac troponin T (cTnT) assay; the contemporary Gen 4 cTnT and high-sensitivity cardiac troponin I (hs-cTnI) assays were unaffected. The biotin interference threshold was 31, 315, and more than 2,000 ng/mL for Gen5 cTnT, cTnT, and hs-cTnI assays, respectively. Streptavidin pretreatment blocked biotin interference in cTn assays. Conclusions Biotin interference is possible at plasma concentrations achievable by ingestion of over-the-counter supplements that may lead to delayed or missed diagnosis of myocardial injury with the Gen5 cTnT assay.",
keywords = "Biotin, Interference, Myocardial infarction, Troponin",
author = "Frame, {Ithiel J.} and Parag Joshi and Caroline Mwangi and Ian Gunsolus and {de Lemos}, {James A} and Das, {Sandeep R} and Ravindra Sarode and Balani, {Jyoti P} and Apple, {Fred S.} and Alagarraju Muthukumar",
year = "2019",
month = "4",
day = "2",
doi = "10.1093/ajcp/aqy172",
language = "English (US)",
volume = "151",
pages = "486--493",
journal = "American Journal of Clinical Pathology",
issn = "0002-9173",
publisher = "American Society of Clinical Pathologists",
number = "5",

}

TY - JOUR

T1 - Susceptibility of cardiac troponin assays to biotin interference

AU - Frame, Ithiel J.

AU - Joshi, Parag

AU - Mwangi, Caroline

AU - Gunsolus, Ian

AU - de Lemos, James A

AU - Das, Sandeep R

AU - Sarode, Ravindra

AU - Balani, Jyoti P

AU - Apple, Fred S.

AU - Muthukumar, Alagarraju

PY - 2019/4/2

Y1 - 2019/4/2

N2 - Objectives To investigate biotin interference on three cardiac troponin (cTn) assays and demonstrate a method to overcome biotin interference. Methods cTn levels were measured in (1) plasma from healthy volunteers on 10-mg daily biotin supplementation mixed with a plasma with known elevated troponin, (2) plasmas with known elevated cTn after mixing in reagent biotin to simulate supplementation, and (3) biotin-spiked plasma specimens pretreated with streptavidin-agarose beads. Results Daily biotin ingestion (10 mg) and studies simulating daily biotin use resulted in significant interference in the Gen5 cardiac troponin T (cTnT) assay; the contemporary Gen 4 cTnT and high-sensitivity cardiac troponin I (hs-cTnI) assays were unaffected. The biotin interference threshold was 31, 315, and more than 2,000 ng/mL for Gen5 cTnT, cTnT, and hs-cTnI assays, respectively. Streptavidin pretreatment blocked biotin interference in cTn assays. Conclusions Biotin interference is possible at plasma concentrations achievable by ingestion of over-the-counter supplements that may lead to delayed or missed diagnosis of myocardial injury with the Gen5 cTnT assay.

AB - Objectives To investigate biotin interference on three cardiac troponin (cTn) assays and demonstrate a method to overcome biotin interference. Methods cTn levels were measured in (1) plasma from healthy volunteers on 10-mg daily biotin supplementation mixed with a plasma with known elevated troponin, (2) plasmas with known elevated cTn after mixing in reagent biotin to simulate supplementation, and (3) biotin-spiked plasma specimens pretreated with streptavidin-agarose beads. Results Daily biotin ingestion (10 mg) and studies simulating daily biotin use resulted in significant interference in the Gen5 cardiac troponin T (cTnT) assay; the contemporary Gen 4 cTnT and high-sensitivity cardiac troponin I (hs-cTnI) assays were unaffected. The biotin interference threshold was 31, 315, and more than 2,000 ng/mL for Gen5 cTnT, cTnT, and hs-cTnI assays, respectively. Streptavidin pretreatment blocked biotin interference in cTn assays. Conclusions Biotin interference is possible at plasma concentrations achievable by ingestion of over-the-counter supplements that may lead to delayed or missed diagnosis of myocardial injury with the Gen5 cTnT assay.

KW - Biotin

KW - Interference

KW - Myocardial infarction

KW - Troponin

UR - http://www.scopus.com/inward/record.url?scp=85064124219&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85064124219&partnerID=8YFLogxK

U2 - 10.1093/ajcp/aqy172

DO - 10.1093/ajcp/aqy172

M3 - Article

C2 - 30715102

AN - SCOPUS:85064124219

VL - 151

SP - 486

EP - 493

JO - American Journal of Clinical Pathology

JF - American Journal of Clinical Pathology

SN - 0002-9173

IS - 5

ER -