As you are probably aware the AACC holds it annual conference next week in L.A. (Los Angeles). Included are lots of NGAL related posters for the distinguished and discerning connoisseur, as well as those who are into Cystanin C and other novelties.
At Medicoinvestor we’ve made your life easier. Our comptetent contributors have read the abstracts (so you don’t have to be bothered with irrelevant articles) below are the posters and the highlight of each poster:
but not only posters deals with NGAL and other biomarkers: There are classes too 🙂
http://direct.aacc.org/am/AMProduct.aspx?ID=7073
http://direct.aacc.org/am/AMProduct.aspx?ID=7145
on to the Posters…..
Subject: Cardiac Markers
Astract (A-02)c Comparison of automated BnP assays with the Alere Triage BnP POC device
introduction: B-type natriuretic peptide (BNP) is used in the emergency room for differential diagnosis of heart failure. The first clinical assay for BNP (TRIAGE,from Alere [formerly Bio-Site]) was approved by the FDA in 2000 and has been used in most clinical studies for BNP. Several manufacturers have developed automated assays to be equivalent to the TRIAGE device, and all recommend the same 100 pg/mL clinical cutoff established using the TRIAGE method. We performed studies comparing the BNP assay* on the Dimension Vista® system from Siemens with BNP assays from Alere and other manufacturers.
Conclusions: There are BNP analyte recovery differences between manufacturers. These differences affect clinical concordance at the cutoff.
The old story – conflicting cutoffs undermine the use of assay’s – not just in the case of NGAL
Abstract (A-12) development of a highly sensitive immunoassay for Cardiac Troponin i for the arChiTeCT® i2000sr and i1000sr analyzersConclusions: These results demonstrate that the ARCHITECT STAT High Sensitive Troponin-I assay is a precise and highly sensitive method for measuring troponin I in human plasma or serum on a high throughput analyzer.Ohh – by the way did we mention that the study is done by abbott 🙂 – same goes for Abstract A-31, A-35 and A-37
Abstract (A-15)Performance evaluation of a new Myoglobin assay on the high- Throughput adVia Chemistry systems
Conclusions: The data demonstrate good performance of the myoglobin assay on the high-throughput ADVIA Chemistry Systems from Siemens Healthcare Diagnostics.
Ohh – by the way did we mention that the study is done by Siemens 🙂
Abstract (A-33)analytical evaluation of Cardiac Troponin i on the radiometer aQT90 FleX, a random access Point-of-Care Testing (PoCT) analyzer
Conclusions: The Radiometer AQT90 FLEX random access analyzer provides an analytically acceptable POCT measurement of cTnI in EDTA and lithium heparin whole blood, and in EDTA and lithium heparin plasma.
Ohh – by the way did we mention that this POC analyzer is in play for NGAL POC testing – at least we heard rumours about that last year
Subject: Clinical Studies/Outcomes
http://www.aacc.org/events/annualmtgdirectory/Documents/AACC_12_Abstracts_E140-E208.pdf
we start off with:
Abstract (E140) Cystatin C/creatinine ratio according to the degree of renal impaiment
conclusion: (practically dismissing Cystani C as a single marker. ) Therefore, it is possible that serum CysC concentrations could underestimate renal dysfunction in adult patients, too. According to this study, we suggest that the combined use of two renal markers can be more helpful to estimate renal function over use of any single marker.
in other words Cystanin C is no match for NGAL….. on to
Abstract (E147) diagnostic usefulness of Neutrophil Gelatinase- associated Liocain (N-GAL) at patients in intensive Care after Cardiac surgery
Concluding: N-GAL could be one of the predictive markers for AKI at patients with cardiac surgery with measurement after 3 hours. Therefore it should be measured at all patients after cardiac surgery because it is marker for more early detection of AKI than creatinine.
“Approximately 500,000 open heart operations, in more than 900 centers, by more than 3,500 cardiac surgeons are performed in the United States annually. Another 500,000 operations at a similar number of centers, by an equal number of surgeons, are performed in the rest of the world.” (quote from http://ats.ctsnetjournals.org/cgi/content/full/65/4/903)
Abstract (E157) Abbott praising themselves (again)
Conclusion:The redesigned ARCHITECT LH assay is a valuable tool in clinical laboratories for the accurate and precise determination of human luteinizing hormone. The redesign improved performance as well as process and run capability compared to the predicate device.
Where Abbott feels the urge to promote their own assays (as in other abstracts 🙁 🙁 )
Abstract (E163) Lack of correlation between urinary and whole blood neutrophil gelatinase-associated lipocalin (nGal)
Conclusions: There is still controversy as to whether the ideal biological matrix for NGAL assessment should be urine instead of blood, serum or plasma. The former biological matrix presents several advantages, including the higher increase of concentration during progression to AKI as well as the overall better diagnostic performance as recently assessed in a large meta-analysis of published studied.
Actually – as we all know a measurement of BOTH urine/blood would be best (hence the ratio-patent)
Abstract E-167 Has the incidence of intravenous Contrast Induced Nephropathy been overestimated (CIN)?
Contrast-enhanced CT scan recipients are, paradoxically, at a lower risk of SCr-defined AKI as compared to noncontrast CT scan recipients, even after accounting for baseline renal function. Increased pre-scan SCr variability is associated with an increased incidence of post-scan AKI independent of contrast administration, suggesting that cases of CIN may be partially explained by dynamic changes in renal function. These results question the utility of SCr as a marker for CIN, as physiologic variability in this analyte likely confounds its diagnostic accuracy, contributing to a high false positive rate and resulting in an overestimation of the incidence of contrast- dependent renal injury.
Abstract (e190) assessment of Cystatin C as an index of allograft Function in Kidney Transplantation
Serum concentration of Cystatin C (CyC) has been proposed as a marker to determine a reduced GFR, but the data of its value in renal transplant patients are conflicted
Conclusions: We conclude that CyC is an efficacious marker as much as creatinine to assess renal function. Urinary CyC levels return to lower levels as the filtered load and tubular function improves.
Subject Proteins/enzymes
http://www.aacc.org/events/annualmtgdirectory/Documents/AACC_12_Abstracts_D76-D106.pdf
Abstract (D81) immunoassay standardization for serum cystatin C in Japan by erM-da471 – mentioning the “competing” and developing biomarker cystanin C
and
Abstract (D106) Towards an assay-independent Cystatin C-Based GFr-Prediction equation.
Conclusion: The groundwork has been made to an “Assay-Independent Cystatin C-Based GFR-Prediction Equation” with well-characterized diagnostic performance, allowing the efficient use of cystatin C as a marker for GFR in clinical settings.
more interesting for us however is.
Abstract (D95) Performance evaluation of Bioporto diagnostics’ neutrophil gelatinase-associated lipocalin (nGal) assay on automated clinical chemistry analyzer hitachi 7600
This Bioporto Diagnostics’ NGAL assay represents a rapid, automated, and precise method for the determination of NGAL in EDTA plasma.. The measurement of NGAL by the Bioporto Diagnostics’ assay may be useful for the prompt diagnosis of AKI.
Abstract (D98) NGAL vs. other Biomarkers of Kidney injury during lithotripsy
study dealing with kidney stone (ouch…):
The urine NGAL level before surgery was 0.68±0.11 pg/ml in patients with kidney stones, and 2.72±0.18 pg/ml at ureteral stones (0.40±0.05 pg/ml in controls). After the first ESWL session, the five times rise of urinary NGAL was found. The above data allow suggesting NGAL as informative biomarker of tubular injury at ESWL and of related occlusive complications.
Subject Point-of-Care testing
http://www.aacc.org/events/annualmtgdirectory/Documents/AACC_12_Abstracts_D31-D75.pdf
interestingly enough – not ONE poster mentions Alere’s Triage System…… it sure looks as if the could use some high-profile-marketing …. hmm how about a NGAL test with a correct Cutoff ????
closing remarks:
Ce n’est pas la souffrance de l’enfant qui est révoltante, en elle même, mais le fait qu’elle n’est pas justifiée.
