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Cardiac array

Product Method Size Catalog Price
Cardiac array B A T (evidence®) 4x45 (180 biochips) EV3689 POA
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INTENDED USE

The Evidence Cardiac Array has been designed for the in vitro simultaneous quantitative detection of multiple related cardiac immunoassays from a single patient sample. The Cardiac Array consists of 4 assays; Troponin I, Myoglobin and Creatine Kinase - MB and Heart - Fatty Acid Binding Protein for use in clinical diagnosis.

CLINICAL SIGNIFICANCE

The biochemical, physiological and mechanical functioning of the heart can be affected by many different disorders. The most common form of heart disease is coronary artery disease. This disease involves arteriosclerosis, stable and unstable angina, an acute myocardial infarction and can lead to cardiac death(1).

At different stages during a cardiac event markers are released which can be measured and therefore allow clinicians to make more accurate clinical decisions when diagnosing a patients heart condition and stage of disease progression.

Currently, diagnosis of myocardial injury involves determination of serum levels of different proteins and enzymes which are markers of myocardial injury.

PRINCIPLE

The Evidence analyzer is a fully automated Biochip Array System. It performs simultaneous quantitative detection of multiple analytes from a single patient sample and therefore carries out sample assays much faster and efficiently than conventional laboratory analyzers. The core technology is the Randox Biochip, a 9 mm(2 )solid substrate containing an array of discrete test regions. A sandwich chemiluminescent immunoassay is employed for the cardiac assays. The light signal generated from each of the test regions on the biochip is detected using state-of-the-art digital imaging technology.

Several different immunoassay based multi-analyte panels have been developed for use on Evidence. The Evidence Cardiac Array quantitatively measures Myoglobin, Troponin I, Creatine KinaseMB and Heart Type Fatty Acid Binding Protein simultaneously.

REFERENCES

1. Wild, D. The Immunology Handbook, Nature Publishing Group, United Kingdom, pp 623-634.

 

Heart-Fatty Acid Binding Protein (H-FABP) Assay

INTENDED USE

The Evidence h-FABP test has been designed for the quantitative measurement of heart type fatty acid binding protein in human serum specimens.

CLINICAL SIGNIFICANCE

Fatty Acid Binding Protein (FABP) is present in the cytoplasm of myocytes. It has an important role in lipid metabolism, binding long chain fatty acids and carrying them in the blood. The heart type isoenzyme of FABP is found in the heart and the skeletal muscles. Like myoglobin, FABP is a low molecular weight protein with a molecular weight of 14-15 kDa and it is also released within 3-6 hours after the onset of chest pain(1).

The release of proteins into plasma due to myocardial muscle damage are important diagnostic parameters to assist in myocardial infarction diagnosis. Like myoglobin, FABP is an early marker for Acute Myocardial Infarction (AMI)(2). h-FABP has been shown to aid in the diagnosis of AMI complementing cardiac Troponin I as it is elevated at a much earlier timepoint (3,4).

PRINCIPLE

The Evidence h-FABP assay is a sandwich chemiluminescent immunoassay for the detection of h-FABP in human serum.

REFERENCES

1. Wild D. (ed), The Immunoassay Handbook, second edition, Nature Publishing Group, London, Basingstoke, New York, 2001.

2. Siegmann-Thoss C, Renneberg R, Glatz JFC, Spener F, Enzyme immunosensor for diagnosis of myocardial infarction, Sensors and Actuators B 30, 1996; 71-76.

3. McCann CJ, et al Novel biomarkers in early diagnosis of acute myocardial infarction compared with cardiac Troponin T. Eur. Heart J. 2008:29;2843-2850

4. Body R. Heart fatty acid binding protein for rapid diagnosis of acute myocardial ifarction in the emergency department. Emerg. Med. J. 2009:26;519-522

 

Myoglobin (MYO) Assay

INTENDED USE

The Evidence Myoglobin test has been designed for the quantitative measurement of myoglobin in human serum specimens to facilitate the diagnosis of cardiac disease.

CLINICAL SIGNIFICANCE

Myoglobin is a haeme protein with a low molecular weight of 17.8 kDa. It is located inside the muscle fibres of the heart and skeletal muscle (1). In the heart, the myoglobin delivers oxygen to the myocardium (the middle muscular layer of the heart wall) and it is Myoglobin that gives the myocardium its deep red color(2).

Myoglobin is released into the bloodstream after an Acute Myocardial Infarction (AMI) occurs and damages the cell membrane of the muscle cells. Elevated levels of Myoglobin can be detected between 2 and 6 hours after an infarction, earlier than most other biochemical markers, with levels peaking within 5 to 18 hours(1, 2).

Myoglobin has been found to be a more reliable marker and hence more useful than CK-MB or Troponin I or T for ruling out an AMI during the critical period when decisions are made regarding chest pain patients(1,1 ).

Simultaneous measurement of a skeletal muscle specific marker such as carbonic anhydrase III, heart type fatty acid binding protein or a cardiac specific marker such as troponin I as well as myoglobin has been suggested to be a good strategy for diagnosis(2).

PRINCIPLE

The Evidence Myoglobin assay is a sandwich chemiluminescent immunoassay for the detection of Myoglobin in human serum.

REFERENCES

1. Tietz NW, Clinical Guide to Laboratory tests, second edition, WB Saunders Company 1990.

2. Wild D. (ed), The Immunoassay Handbook, second edition, Nature Publishing Group, London, Basingstoke, New York, 2001.

 

Troponin I (cTnI) Assay

INTENDED USE

The Evidence Troponin I test has been designed for the quantitative measurement of cardiac Troponin I in human serum specimens to facilitate the diagnosis of cardiac disease.

CLINICAL SIGNIFICANCE

Cardiac Troponin I (cTnI), a myofibrillar protein with a molecular mass of 25 kDa, is part of a complex of proteins that regulates the contraction of the heart muscle. The troponin complex consists of actin, myosin and troponin. Troponin consists of three subunits; T, I and C. It is cTnI that functions in regulating the actinomyosin ATPase and so prevents muscle contraction in the absence of calcium. Only 2% of the cTnI is free in the cytosol, the rest is myofibrillar-bound. Troponin I exists in several isoforms but the cardiac isoform, cTnI, is specific to heart tissue. cTnI measurements are therefore completely specific for cardiac damage and so it is one of the common biochemical markers used in the clinical decision making to confirm or exclude a diagnosis of Acute Myocardial Infarction (AMI)(1, 2).

After an AMI, damage to the cardiac myocytes causes cTnI to leak out of these cardiac cells and enter into the circulation. cTnI rises 4-8h post-AMI, peaks between 14 and 36 h, and remains elevated for 3-7 days(4). Over the succeeding days after an AMI, there is degradation of the myofibrillar elements and a release of the ternary troponin complex.

cTnI is a useful assay for determining the risk of patients with unstable angina. Clinical trials have demonstrated that patients with unstable angina and elevated troponin levels had an increased risk of cardiac death or acute myocardial infarction within 4 weeks of diagnosis on comparison to a group of unstable angina patients with normal troponin levels. cTnI may also be an important marker for assessing whether patients should receive antithrombotic and anti-platelet drugs as those with a high cardiac troponin will benefit most from these therapies(3).

As mentioned this assay has a high clinical specificity for heart damage and is elevated after AMI. The measurement of elevated cTnI with normal levels of CK-MB in the serum indicates myocardial damage not detected by conventional markers (2).

PRINCIPLE

The Evidence cTnI assay is a sandwich chemiluminescent immunoassay for the detection of cTnI in human serum.

REFERENCES

1 Wild D. (ed), The Immunoassay Handbook, second edition, Nature Publishing Group, London, Basingstoke, New York, 2001.

2 Collinson PO, Troponin T or Troponin I or CK-MB (or none), European Heart Journal, 1998; 19:(supplement N), N16-N24.

3. Wu AHB and Feng YJ, Biochemical differences between cTnT and cTnI and their clinical significance for diagnosis of acute coronary syndromes, European Heart Journal, 1998; 19: Supplement N, N25-N29.

4. Apple FS, Cardiac Markers, Edited by Alan H B. Wu, Humana Press Inc., Totowa, New Jersey, 1998.

 

Creatine-Kinase MB (CK-MB) Assay

INTENDED USE

The Evidence CK-MB test has been designed for the quantitative measurement of creatine kinase MB in human serum specimens to facilitate the diagnosis of cardiac disease.

CLINICAL SIGNIFICANCE

Creatine Kinase is a dimeric protein composed of two enzymatically active M (muscle-type) and B (brain-type) subunits. It has three cytosolic isoenzymes and CK-MB is the isomeric form described here. CK-MB is found predominantly in cardiac muscle and makes up 30% of the total CK in cardiac muscle. However, it is not cardio-specific, a very small proportion - less than 1% of the total CK-MB is found in skeletal muscle.

Measurement of CK-MB instead of total CK enhances the specificity of the assay as it is more specific to cardiac damage. After an AMI, the level of CK-MB in the blood will increase within the first 4-6 hours after the onset of chest pain. The level of CK-MB will then peak at 18-24 hours and return to normal within 72 hours. The activity of CK-MB declines mono-exponentially if there are no further events of ischemic injury(1).

PRINCIPLE

The Evidence CK-MB assay is a sandwich chemiluminescent immunoassay for the detection of CK-MB in human serum.

REFERENCES

1. Wild D. (ed), The Immunoassay Handbook, second edition, Nature Publishing Group, London, Basingstoke, New York, 2001.

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