Development of saliva-based cardiac troponin I point-of-care test using alpha-amylase depletion: a feasibility study

Roi Westreich*, Gal Tsaban, Yoav Neumann, Amjad Abu Salman, Omri Braver, Dana Braiman, Tali Zamed, Zipora Feiga Neuhaus, Omer Deutsch, Aaron Palmon, Nimrod Maimon, Doron Zahger, Yigal Abramowitz

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Introduction: Cardiac troponin (cTn) is the biomarker of choice for detection of myocardial injury. There is a great need for simple point-of-care (POC) troponin testing among patients with chest pain, mainly in the prehospital setting. The purpose of this study was to evaluate the presence of cardiac troponin I (cTnI) in saliva of patients with myocardial injury using alpha-amylase depletion technique. Methods: Saliva samples were collected from 40 patients with myocardial injury who were tested positive for conventional high-sensitivity cardiac troponin T (cTnT) blood tests, and from 66 healthy volunteers. Saliva samples were treated for the removal of salivary alpha-amylase. Treated and untreated samples were tested with blood cTnI Rapid Diagnostic Test. Salivary cTnI levels were compared to blood cTnT levels. Results: Thirty-six of 40 patients with positive blood cTnT had positive salivary samples for cTnI following alpha-amylase depletion treatment (90.00% sensitivity). Moreover, three of the four negative saliva samples were obtained from patients with relatively low blood cTnT levels of 100 ng/L or less (96.88% sensitivity for 100 ng/L and above). The negative predictive value was 93.65% and rose up to 98.33% considering the 100 ng/L cutoff. Positive predictive values were 83.72% and 81.58%, respectively. Among 66 healthy volunteers and 7 samples yielded positive results (89.39% specificity). Conclusion: In this preliminary work, the presence of cTnI in saliva was demonstrated for the first time to be feasibly identified by a POC oriented assay. The specific salivary alpha-amylase depletion technique was shown to be crucial for the suggested assay.

Original languageAmerican English
Pages (from-to)351-355
Number of pages5
JournalCoronary Artery Disease
Volume34
Issue number5
DOIs
StatePublished - 1 Aug 2023

Bibliographical note

Publisher Copyright:
Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • amylase depletion
  • myocardial injury
  • point-of-care test
  • saliva
  • troponin

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