Evaluation of Diagnostic Efficacy of Novel Red Blood Cell Parameters as Potential Screening Test for Detecting Latent Iron Deficiency in Blood Donors.

Iron deficiency anemia (IDA) forms a major share of global burden of anemia. Frequent blood donation is a common iatrogenic cause of iron insufficiency in healthy adults. Serum iron and hemoglobin levels are normal despite low serum ferritin levels, referred to as latent iron deficiency (LID). Aim of the present study was to evaluate the role of novel RBC parameters-percentage of hypochromic RBCs (%HPO), percentage of microcytic RBCs (%MIC), and haemoglobin content of reticulocytes (MCHr) of Abbott Alinity autoanalyzer as indicators of latent iron deficiency in blood donors. 260 consenting and eligible blood donors were included in the study. Complete blood counts including new RBC parameters on Abbott Alinity autoanalyzer and serum iron profile were measured for all donors. Donors were categorized into LID and No LID based on Ferritin and Transferrin saturation (TSAT). Serum transferrin receptors (sTfR) were studied in a subset of samples [LID (n = 46), No LID (n = 18) and IDA (n = 27)]. Statistical analyses was done on IBM SPSS version 22. Among 260 donors, 56 (21.5%) were found to have LID. The difference in mean values for % HPO, % MIC, and MCHr were not found to be statistically significant in LID and No LID groups. sTfR results between LID, No LID and IDA sub-groups revealed significant difference. This study does not support the role of % HPO, % MIC and MCHr measured on Abott Alinity analyzer, as potential screening parameters for LID amongst blood donors. STfr was more informative in this regard. Further research on much larger sample size is required to confirm these findings. Supplementary Information: The online version contains supplementary material available at 10.1007/s12288-023-01683-w.

Evaluation of Dual Marker Approach Using Heart-Type Fatty Acid Binding Protein and High Sensitivity Troponin-I as an Alternative to Serial Sampling for Diagnosis of Acute Myocardial Infarction.

Objective: An early rule in (high specificity and high PPV) and early rule out (high sensitivity and high NPV) is essential for diagnosing acute myocardial infarction (AMI) to provide better utilization of resources, cost-effectiveness, and to reduce mortality. Methods: Consecutive chest pain patients (n=80) with symptoms indicative of coronary artery disease reported to the emergency room within 6 hours after onset of symptoms. An alternate Dual Marker Approach (DMA; both Heart-type Fatty Acid Binding Protein (H-FABP) and High sensitive Troponin-I (hsTnI) at 0 h) was compared to the Double Sampling approach (DSA; hsTnI at 0 h and 3 h (ESC guidelines)). Results: If both biomarkers were increased (n=17; 77.5%: 11 STEMI and 6 NSTEMI) above their respective cut-off value (HFABP 6.3 ng/mL and hsTnI 20.24 ng/L) at presentation, AMI ensued (100% PPV). Also, if both the markers were below their respective cut-offs at presentation, AMI was safely ruled out (n=41; with only 1 false negative). However, among the patients with either of these markers above their respective cut-off at presentation (n=22), DSA was required to find remaining AMI cases (n=4). Overall, DMA stands best for rule out (sensitivity 95.5%, NPV 97.6%) while DSA is superior for rule in (98.2% specificity, 95.2% PPV). Conclusion: With the use of the proposed DMA, 58/80 (72.5%) patients with acute chest pain were reliably ruled in/ruled out for AMI at the presentation itself, while the remaining patients still required serial monitoring (DSA) for confirmation.