Validation of Becton Dickinson Barricor™ tubes for use with Abbott Alinity™ and Siemens Atellica® highly sensitive cardiac troponin I measuring systems.

Abstract

Background: BD Barricor^™ tubes have been proposed to decrease laboratory turnaround time (TAT). We analytically validated and then clinically verified these tubes for use with Abbott Alinity^™ and Siemens Atellica^® highly sensitive cardiac troponin I (hs-cTnI) assays.

Methods: hs-cTnI measurements were undertaken in paired Barricor^™ and in-use PSTII^™ tubes on both systems. 359 matched samples with hs-cTnI levels between 3 and 15,000 ng/L (Atellica^® values) were used to assess the hemolysis rate and make method comparisons. 599 paired patient samples were collected on emergency department (ED) admission to compare the performance of the rapid acute myocardial infarction (AMI) rule-out strategy based on hs-cTnI concentrations lower than recommended thresholds (<4 ng/L Alinity^™; <5 ng/L Atellica^®) when different tubes and systems were employed.

Results: No between-tube differences in hemolysis rate were seen when free hemoglobin concentrations in plasma samples were ≥0.25 g/L, even if PSTII^™ showed a significant increase of hemolysis rate vs. Barricor^™ (31% vs. 22%, p=0.007) when a lower cut-off for hemolysis (≥0.11 g/L) was employed on the Atellica^® detection system. The alternate use of these tubes did not influence the hs-cTnI results obtained from either of the two assays, which remained markedly biased (~40%) irrespective of the tube used. The expected optimal ability of very low hs-cTnI values on ED admission for ruling out AMI was confirmed by using both systems regardless of the tube type.

Conclusions: Barricor^™ and PSTII^™ tubes can provide analytically equivalent hs-cTnI results when used on either Alinity^™ or Atellica^® hs-cTnI assays.