Generic placeholder image

Combinatorial Chemistry & High Throughput Screening

Author(s): Mustafa Begenc Tascanov and Ataman Gönel*

DOI: 10.2174/1386207322666190603170438

DownloadDownload PDF Flyer Cite As
How Do Contrast Agents Affect Cardiac Markers and Coagulation Tests? Experimental Study

Page: [355 - 360] Pages: 6

  • * (Excluding Mailing and Handling)

Abstract

Background: The discovery that biotin interferes with results of troponin and Nt-proBNP led some commercial firms to update their measurement methods. In particular, the clinical incompatibility of cardiac test results may affect the risk of morbidity and mortality.

Objective: The aim of this study is to investigate the interference effects of 7 different contrast agents on cardiac markers (Troponin-I, Nt-proBNP, Mass CK-MB, CK, AST, LDH) and in coagulation tests (PT, APTT).

Methods: Seven different contrast media were added into control materials by using interference protocol. The concentrations of PT, APTT, CK, AST, LDH, Mass CK-MB, Troponin-I, and Nt-proBNP were measured by Sysmex CS-2100, Abbott c16000, Siemens Centaur XP and AFİAS-6 analyzer. The number of deviations from target values was calculated.

Results: The 7 different contrast media caused negative interference in troponin levels between 57.43% and 62.87%. It was found that different contrast media produced false negativity in the Nt-proBNP test, ranging from 6.11% to 96.01%. Enzymes and coagulation tests were less affected.

Conclusion: Different contrast media may cause false negatives in cTnI and Nt-proBNP. The contrast medium that causes the least interference should be preferred. The results of samples taken in the first hour after contrast imaging should be interpreted with care.

Keywords: Contrast media, troponin, Nt-proBNP, interference, cardiac markers, coagulation test.

[1]
Lightfoot, C.B.; Abraham, R.J.; Mammen, T.; Abdolell, M.; Kapur, S.; Abraham, R.J. Survey of radiologists’ knowledge regarding the management of severe contrast material-induced allergic reactions. Radiology, 2009, 251(3), 691-696. [http://dx.doi.org/10.1148/radiol.2513081651]. [PMID: 19474374].
[2]
Trambas, C.; Lu, Z.; Yen, T.; Sikaris, K. Characterization of the scope and magnitude of biotin interference in susceptible Roche Elecsys competitive and sandwich immunoassays. Ann. Clin. Biochem., 2018, 55(2), 205-215. [http://dx.doi.org/10.1177/0004563217701777]. [PMID: 28875734].
[3]
Willeman, T.; Casez, O.; Faure, P.; Gauchez, A.S. Evaluation of biotin interference on immunoassays: new data for troponin I, digoxin, NT-Pro-BNP, and progesterone. Clin. Chem. Lab. Med., 2017, 55(10), e226-e229. [CCLM]. [http://dx.doi.org/10.1515/cclm-2016-0980]. [PMID: 28222017].
[4]
Normann, P.T.; Frøysa, A.; Svaland, M. Interference of gadodiamide injection (OMNISCAN) on the colorimetric determination of serum calcium. Scand. J. Clin. Lab. Invest., 1995, 55(5), 421-426. [http://dx.doi.org/10.3109/00365519509104981]. [PMID: 8545600].
[5]
Otnes, S.; Fogh-Andersen, N.; Rømsing, J.; Thomsen, H.S. Analytical interference by contrast agents in biochemical assays. Contrast Media & Mol. Imaging, 2017. [http://dx.doi.org/10.1155/2017/1323802].
[6]
Idée, J.M.; Port, M.; Raynal, I.; Schaefer, M.; Le Greneur, S.; Corot, C. Clinical and biological consequences of transmetallation induced by contrast agents for magnetic resonance imaging: a review. Fundam. Clin. Pharmacol., 2006, 20(6), 563-576. [http://dx.doi.org/10.1111/j.1472-8206.2006.00447.x]. [PMID: 17109649].
[7]
Proctor, K.A.; Rao, L.V.; Roberts, W.L. Gadolinium magnetic resonance contrast agents produce analytic interference in multiple serum assays. Am. J. Clin. Pathol., 2004, 121(2), 282-292. [http://dx.doi.org/10.1309/MGA3LC4X8CGLX9CH]. [PMID: 14983944].
[8]
Zhang, H.L.; Ersoy, H.; Prince, M.R. Effects of gadopentetate dimeglumine and gadodiamide on serum calcium, magnesium, and creatinine measurements. J. Magn. Reson. Imaging, 2006, 23(3), 383-387. [http://dx.doi.org/10.1002/jmri.20517]. [PMID: 16463306].
[9]
Frenzel, T.; Lengsfeld, P.; Schirmer, H.; Hütter, J.; Weinmann, H.J. Stability of gadolinium-based magnetic resonance imaging contrast agents in human serum at 37 degrees C. Invest. Radiol., 2008, 43(12), 817-828. [http://dx.doi.org/10.1097/RLI.0b013e3181852171]. [PMID: 19002053].
[10]
Fretellier, N.; Poteau, N.; Factor, C.; Mayer, J-F.; Medina, C.; Port, M.; Idée, J-M.; Corot, C. Analytical interference in serum iron determination reveals iron versus gadolinium transmetallation with linear gadolinium-based contrast agents. Invest. Radiol., 2014, 49(12), 766-772. [http://dx.doi.org/10.1097/RLI.0000000000000081]. [PMID: 24943092].
[11]
Corot, C.; Idée, J-M.; Hentsch, A.M.; Santus, R.; Mallet, C.; Goulas, V.; Bonnemain, B.; Meyer, D. Structure-activity relationship of macrocyclic and linear gadolinium chelates: investigation of transmetallation effect on the zinc-dependent metallopeptidase angiotensin-converting enzyme. J. Magn. Reson. Imaging, 1998, 8(3), 695-702. [http://dx.doi.org/10.1002/jmri.1880080328]. [PMID: 9626889].
[12]
Niendorf, H.P.; Seifert, W. Serum iron and serum bilirubin after administration of Gd-DTPA-dimeglumine. A pharmacologic study in healthy volunteers. Invest. Radiol., 1988, 23(Suppl. 1), S275-S280. [http://dx.doi.org/10.1097/00004424-198809001-00060]. [PMID: 3198362].
[13]
Lin, C.T.; Lee, H.C.; Voon, W.C.; Yen, H.W.; Tang, M.H.; Chin, T.T.; Chen, W.R.; Chien, W.T.; Lai, W.T.; Sheu, S.H. Positive interference from contrast media in cardiac troponin I immunoassays. Kaohsiung J. Med. Sci., 2006, 22(3), 107-113. [http://dx.doi.org/10.1016/S1607-551X(09)70229-3]. [PMID: 16602274].
[14]
Hayakawa, K.; Okuno, Y.; Fujiwara, K.; Shimizu, Y. Effect of iodinated contrast media on ionic calcium. Acta Radiol., 1994, 35(1), 83-87. [http://dx.doi.org/10.1177/028418519403500117]. [PMID: 8305280].
[15]
Bossuyt, X. Interferences in clinical capillary zone electrophoresis of serum proteins. Electrophoresis, 2004, 25(10-11), 1485-1487. [http://dx.doi.org/10.1002/elps.200305820]. [PMID: 15188230].
[16]
Poirey, S.; Polge, A.; Bertinchant, J.P.; Bancel, E.; Boyer, J.C.; Fabbro-Peray, P.; de Bornier, B.M.; Ledermann, B.; Bonnier, M.; Bali, J.P. CK-MB mass test in ischemic myocardial injury. Comparison of two tests: BioMerieux Vidas and sanofi access immunoassays. J. Clin. Lab. Anal., 2000, 14(2), 43-47. [http://dx.doi.org/10.1002/(SICI)1098-2825(2000)14:2<43:AID-JCLA1>3.0.CO;2-6]. [PMID: 10683612].
[17]
Kim, S.; Um, T.H.; Cho, C-R.; Jeon, J-S. False-positive elevation of creatine kinase MB mass concentrations caused by macromolecules in a patient who underwent nephrectomy for renal cell carcinoma. Ann. Lab. Med., 2014, 34(5), 405-407. [http://dx.doi.org/10.3343/alm.2014.34.5.405]. [PMID: 25187898].
[18]
Samarasinghe, S.; Meah, F.; Singh, V.; Basit, A.; Emanuele, N.; Emanuele, M.A.; Mazhari, A.; Holmes, E.W. Biotin interference with routine clinical immunoassays: Understand the causes and mitigate the risks. Endocr. Pract., 2017, 23(8), 989-998. [http://dx.doi.org/10.4158/EP171761.RA]. [PMID: 28534685].
[19]
Eriksson, S.; Halenius, H.; Pulkki, K.; Hellman, J.; Pettersson, K. Negative interference in cardiac troponin I immunoassays by circulating troponin autoantibodies. Clin. Chem., 2005, 51(5), 839-847. [http://dx.doi.org/10.1373/clinchem.2004.040063]. [PMID: 15718489].
[20]
Eriksson, S.; Junikka, M.; Laitinen, P.; Majamaa-Voltti, K.; Alfthan, H.; Pettersson, K. Negative interference in cardiac troponin I immunoassays from a frequently occurring serum and plasma component. Clin. Chem., 2003, 49(7), 1095-1104. [http://dx.doi.org/10.1373/49.7.1095]. [PMID: 12816906].
[21]
Volk, A.L.; Hardy, R.; Robinson, C.A.; Konrad, R.J. False-positive cardiac troponin I results: Two case reports. Lab. Med., 1999, 30(9), 610-612. [http://dx.doi.org/10.1093/labmed/30.9.610].
[22]
Hawkins, R.C. Hemolysis interference in the ortho-clinical diagnostics vitros ECi cTnI assay. Clin. Chem., 2003, 49(7), 1226-1227. [http://dx.doi.org/10.1373/49.7.1226]. [PMID: 12816934].
[23]
Lum, G.; Solarz, D.E.; Farney, L. False positive cardiac troponin results in patients without acute myocardial infarction. Lab. Med., 2006, 37(9), 546-550. [http://dx.doi.org/10.1309/T94UUXTJ3TX5Y9W2].
[24]
Ayan, M. Gheith, Z.; Ananthula, A.; Salih, M.; Vallurupalli, S.; Mehta. J.L. In Baylor University Medical Center Proceedings., 2018, Vol. 31, 197-199.
[25]
Lin, C-T.; Lee, H-C.; Voon, W-C.; Yen, H-W.; Tang, M-H.; Chin, T-T.; Chen, W-R.; Chien, W-T.; Lai, W.T.; Sheu, S.H. Positive interference from contrast media in cardiac troponin I immunoassays. Kaohsiung J. Med. Sci., 2006, 22(3), 107-113. [http://dx.doi.org/10.1016/S1607-551X(09)70229-3]. [PMID: 16602274].
[26]
Tsutamoto, T.; Wada, A.; Maeda, K.; Hisanaga, T.; Maeda, Y.; Fukai, D.; Ohnishi, M.; Sugimoto, Y.; Kinoshita, M. Attenuation of compensation of endogenous cardiac natriuretic peptide system in chronic heart failure: prognostic role of plasma brain natriuretic peptide concentration in patients with chronic symptomatic left ventricular dysfunction. Circulation, 1997, 96(2), 509-516. [http://dx.doi.org/10.1161/01.CIR.96.2.509]. [PMID: 9244219].
[27]
Koglin, J.; Pehlivanli, S.; Schwaiblmair, M.; Vogeser, M.; Cremer, P.; vonScheidt, W. Role of brain natriuretic peptide in risk stratification of patients with congestive heart failure. J. Am. Coll. Cardiol., 2001, 38(7), 1934-1941. [http://dx.doi.org/10.1016/S0735-1097(01)01672-2]. [PMID: 11738297].
[28]
Janssen, M.J.; Velmans, M.H.; Heesen, W.F. A patient with a high concentration of B-type natriuretic peptide (BNP) but normal N-terminal proBNP concentration: A case report. Clin. Biochem., 2014, 47(12), 1136-1137. [http://dx.doi.org/10.1016/j.clinbiochem.2014.05.051]. [PMID: 24863962].
[29]
Xiaohong, P.; Jian-An, W. False-positive BNP results caused by human antimouse antibodies (HAMAs) interference: A case report. Heart, 2011, 97(Suppl. 3), A105-A105. [http://dx.doi.org/10.1136/heartjnl-2011-300867.311].
[30]
Saenger, A.K.; Rodriguez-Fraga, O.; Ler, R.; Ordonez-Llanos, J.; Jaffe, A.S.; Goetze, J.P.; Apple, F.S. Specificity of B-type natriuretic peptide assays: Cross-reactivity with different BNP, NT-proBNP, and proBNP peptides. Clin. Chem., 2017, 63(1), 351-358. [http://dx.doi.org/10.1373/clinchem.2016.263749]. [PMID: 28062628].