engleski

Preanalytical considerations of urine troponin I analysis - a case report

BACKGROUND-AIM: Serum high sensitivity troponin I is measured in serum. However, some studies have assessed its potential in first morning urine sample. Despite intriguing results, preanalytical factors should be considered before any clinical use. It was also noticed that troponin levels may be increased after high endurance exercise. The aim of our study was to investigate hsTnI level in urine sample during 7 day period which included wide range of physical activity. METHODS: Urine hsTnI and creatinine levels have been monitored in 35 years old female recreational runner during 7 day period (Tuesday to Monday). hsTnI and creatinine levels were analyzed in first morning urine sample on Abbott i2000 analyzer and Abbott c8000 respectively. Tuesday (day 1): sample without prior physical activity. 5 km training in the evening. Wednesday (day 2): sample after activity. Thursday (day 3): sample without physical activity. 4, 41 km in the evening. Friday (day 4): sample after physical activity. Saturday (day 5): 18 km trail race. Sample was taken 4 hours after finishing the race. Sunday (day 6): first morning sample stored at 4oC, hsTnI was measured next day. Monday (day 7): first morning sample. RESULTS: hsTnI (ng/L) and creatinine (mmol/L) levels on day 1 were 27ng/L and 6.3mmol/L ; day 2: 8ng/L and 10.4mmol/L ; day 3: 9ng/L and 7.9mmol/L ; day 4: 13ng/L and 9.5mmol/L ; day 5: 48ng/L and 10.6mmol/l ; day 6: 0ng/L and 16.3mmol/L ; day 7: 4ng/L and 5.6mmol/L. hsTnI/ creatinine ratio was: 4.29 ; 0.77 ; 1.14 ; 1.37 ; 4.53 ; 0 ; 0.71 respectively. Urine sediment analysis revealed presence of bacteria in samples after race. CONCLUSIONS: The highest hsTnI level was measured in a sample after race. However, hsTnI/creatinine ratio was similar to the ratio on the first day without prior increase in physical activity, suggesting effect of hydration on troponin level in urine. hsTnI was measurable in every sample except for sample 6, analyzed the next day suggesting possible degradation of hsTnI in urine, possibly due to presence of bacteria.

urine, troponin I, physical activity

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