Abstract 227: A Liquid Chromatography-Mass Spectrometry Assay for the Semi-quantitative Screening of 34 Cardiovascular Medications in Human Serum
Background Cardiovascular medications are the most commonly prescribed drugs; there is need for an objective method to distinguish patients with ineffective regimens from those with medication non-adherence.
Methods We developed a liquid chromatography mass spectrometry (LC-MS) method for semi-quantitative drug detection of 34 commonly prescribed cardiovascular drugs using 100μl of serum. Drug classes include: anticoagulants, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, beta blockers, calcium channel blockers, diuretics, statins, vasodilators, digoxin, fenofibrate, and niacin. Analytical accuracy and precision were evaluated by repeating the assay on spiked samples at low, medium and high concentrations. In 294 clinical samples collected from hospitalized patients, statistical sensitivity, specificity, and accuracy were computed by comparing the detection or lack thereof against documented drug administration.
Results For the 34 cardiovascular drugs, the assay was sensitive (>0.90) for all except captopril (0.25), isosorbide (0.81), and niacin (0.89). The assay was specific for all drugs, with a minimum specificity of 0.94 (aspirin).
Conclusions To our knowledge, this method is the first high-throughput,semi-quantitative LC-MS method for simultaneous analysis of 34 commonly prescribed cardiovascular drugs across multiple classes that has been validated in serum obtained from patients during supervised medication administration. This assay provides a simple tool to determine adherence.
- © 2013 by American Heart Association, Inc.