![]() ![]() 2)- The large number of commercially available troponin assays that differ from one another in terms of antibody-epitope specificity and preclude direct comparison of results from various studies. These include: 1)- The general lack of appropriate analytical validation which can lead to erroneous interpretation of results and subsequent designation of reference ranges and threshold cut-off points. There are problems however, associated with the clinical utility and application of the troponin assays reported in the equine literature to date. al.), and recently two reports use the hscTnT assay. Older generation (‘non-hs’) troponin assay use in veterinary medicine has been fairly widespread (reviewed by Rossi et. Troponin-I and T assays with total imprecision ≤ 10 % at the 99 th percentile, and measurable normal values below the 99 th percentile in at least 50 % of healthy individuals are now classified as’high-sensitivity’ assays in humans. The assays have evolved through numerous generations, each of which has undergone improvements in analytical performance. Since 2000, after an extensive search for a biomarker of myocardial damage with sufficient analytical sensitivity and specificity, troponin assays have been deemed the test of choice for detection of acute myocardial injury (AMI) in humans. Of the three troponin subunits, only cardiac Troponin-T (cTnT) and cardiac Troponin-I (cTnI) have unique amino acid sequences expressed as cardiac muscle-specific isoforms, and are encoded by different genes than the troponins expressed in skeletal muscle. One cardiac diagnostic tool that has been adopted for use in veterinary medicine is the troponin assay. Early detection of cardiac pathologies would provide the opportunity to recognize occult disease and allow intervention prior to potentially more serious outcomes such as cumulative cardiac damage or sudden death. Similarly, determining the impact of any cardiovascular abnormality on present or future performance, on rider or driver safety, and the long-term effects on health and longevity can be problematic. Two clinical cases demonstrated further the clinical utility of the assay.Īs acknowledged in a recent joint consensus statement, subtle or occult cardiac abnormalities are often difficult to diagnose in horses. This benchmark study is the first to comply with CLSI guidelines, thus further establishing the performance characteristics of the hscTnT assay, and reference intervals in healthy horses. ![]() Two clinical cases with presumed cardiac pathology had hscTnT levels of 220.9 ng/L and 5723.0 ng/L. Between-breed, diurnal effect, and between-day variation was below LoQ. Reference intervals: The upper 95 th and 99 th percentile of the hscTnT population distribution were 6.8 and 16.2 ng/L in Non-Competition Horses, and 14.0 and 23.2 ng/L in Racing-Thoroughbreds. Comparison with cTnI assay showed excellent correlation (range: 8.0–3535.0 ng/L, R 2 = 0.9996). Samples demonstrated insignificant decay over freeze-thaw cycle. HscTnT levels were measured in two horses with cardiac pathology. Reference intervals and biological variation were determined using adult, healthy, Non-Competition Horses (N = 125) and Racing-Thoroughbreds (N = 178). Methods: Analytical validation of the Roche hscTnT assay included within- and between-run precision, linear dose response, limit of quantitation (LoQ), stability, and comparison with cTn-I (iSTAT). Objective: Appropriately validate the’high-sensitivity’ cardiac Troponin-T (hscTnT) assay for clinical use in horses, establish reference intervals, determine the biological variation, and demonstrate assay utility in selected clinical cases. Cardiac troponin-I assays have been validated in horses.’High-sensitivity’ cardiac troponin assays are now the standard in human cardiology.
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