Cardiac biomarkers and quality spotlight Clinical Biochemistry’s hot topics session (33122) at the 69th AACC Annual Scientific Meeting & Clinical Lab Expo, held this year in conjunction with the Canadian Society of Clinical Chemists (CSCC). This Aug. 1 morning symposium will cover research published in Clinical Biochemistry and other top-tier journals about the release mechanisms, utility, and quality of cardiac biomarkers, and about the use of external quality assurance (EQA) data to establish new models for managing laboratory testing.

All hot topics sessions are based on highly cited journal articles during the past year.

Starting off the session, Ola Hammarsten, MD, PhD, an associate professor at University of Gothenburg’s Department of Clinical Chemistry and Transfusion Medicine will discuss two papers recently published in Clinical BiochemistryClearance of cardiac troponin T (cTnT) with and without kidney function; and High-sensitive cardiac troponin, N-terminal pro-brain natriuretic peptide, human fatty acid-binding protein and copeptin levels in relation to glomerular filtration rates and a medical record of cardiovascular disease.

In an abstract summarizing his talk, Hammarsten wrote, “cTnT is cleared via both renal and extra renal mechanisms. Recent studies indicate that stable cTnT elevations may not always be due to increased release from the heart but also due to decreased clearance.” 

Both renal and extrarenal clearance of proteins are known to decrease as a consequence of aging. This potentially explains the strong link between stable cTnT elevations, patient age, and mortality, he wrote.

Tony Badrick, PhD, FACB, FFSc(RCPA), FRCPA(Hon) will helm the second hot topics session on internal quality control (IQC) and EQA. IQC and EQA are related processes that have developed independently in laboratory medicine over many years, according to Badrick, chief executive of the Royal College of Pathologists of Australasia Quality Assurance Programs in St. Leonards, New South Wales, Australia.

Each has different sample frequencies, statistical interpretations, and immediacy, Badrick wrote in an overview of his presentation. Both processes have evolved as far as grasping the concept of laboratory error, sample material matrix, and assay capability.

However, neither approach has led as of late to much improvement in patient outcomes. “It is the increasing reliability and automation of analytical platforms along with improved stability of reagents that has reduced systematic and random error which in turn has minimized the risk of running less frequent IQC,” Badrick said.

His suggestion has been to merge the two approaches, using an Average of Normals (AoN) model supported by more frequent EQA samples. 

Badrick explained to CLN Stat that he and his colleagues have been developing a variant of the AoN, “looking at an average of standard deviation of the truncated population as well as a model that looks at the number of positive patient results for a test that classifies patients into a diseased or nondiseased category, such as prostate-specific antigen in post prostatectomy patients.”

This new paradigm should create less confusion for laboratory staff and make it easier to quickly identify and respond to situations that get out of control, he indicated.

This session runs from 10:30 a.m. until noon and is worth 1.5 CE hours. Register today for the 69th AACC Annual Scientific Meeting & Clinical Lab Expo in San Diego July 30-Aug. 3 to participate in this informative event.