- E-postkristin.aakre@uib.no
- Telefon+4755974387
- BesøksadresseHaukeland universitetssykehus, Laboratoriebygget5009 Bergen
- PostadressePostboks 78045020 Bergen
Kristin M Aakre is a medical doctor. She is board certified in laboratory medicine since 2009 and completed her PhD in 2011 (University of Bergen).
She is PI of several large research trials manly focusing on diagnostic and prognostic properties of cardiac biomarkers, with a particular focus on acute coronary syndrome. She has also published within biological variation and analytical quality specifications, mainly related to cardiac biomarkers. She is interested in guideline development and currently chair of the International Federation of Clinical Chemistry Committee on Clinical Application of Cardiac Markers, and has participated in several national and international working groups within laboratory medicine.
Supervision
PhD fellows (main supervisor)
1. Hilde L Tjora: Early rule-out of acute coronary syndrome in the emergency department-the WESTCOR study. 3 year PhD grant from Western Norway Regional Health Authority. Dissertation 23. August 2022, University of Bergen.
Ongoing PhD fellows (main supervisor)
1. Ingar Z Restan: Safe and efficient follow-up of patients with chest pain-the WESTCOR-study. 6 year PhD grant from Western Norway Regional Health Authority
2. Gard MS Myrmel: Growth Differentiation Factor - 15 as a predictor of atherosclerotic coronary artery disease, chronic myocardial injury and long-term prognosis. 6 year PhD grant from Western Norway Regional Health Authority
Ongoing PhD fellows (co-supervisor)
1. Ole-Thomas Steiro Andresen: Early identification of coronary disease: Clinical risk scores, symptom typicality and novel cardiac biomarkers.
2. Magnus F Bjørkavoll-Bergseth. The relationship between exercise induced cardiac Troponin increase and physical workload during prolonged strenuous exercise (NEEDED 2018). 3 year PhD grant from Western Norway Regional Health Authority.
3. Iman Karaji. Advanced Coronary CT Angiography in Suspected Coronary Heart Disease. 6 year PhD grant from Western Norway Regional Health Authority
4. Eirik Røys. Novel methods for estimating biological variation. 3 year PhD grant from Western Norway Regional Health Authority
Medical Student Research Program
1. Nasir Saeed: Follow-up of Patients after Admission for Acute Chest Pain - a sub-study of the WESTCOR-study
Master degrees
1. Eirik Røys: Stability of components measured in venous blood gas analyses.
2. Vegard Ø Bonsaksen and Magnus Abrahamsen: Master thesis for medical students: Establishing reference intervals for 5HIAA
- (2024). Imprecision of high-sensitivity cardiac troponin assays at the female 99th-percentile. Clinical Biochemistry.
- (2023). The liver-heart axis in patients with severe obesity: The association between liver fibrosis and chronic myocardial injury may be explained by shared risk factors of cardiovascular disease. Clinical Biochemistry. 8 sider.
- (2023). Prognostic value of growth differentiation factor-15 3 months after an acute chest pain admission. Heart. 9 sider.
- (2023). Prognostic significance of chronic myocardial injury diagnosed by three different cardiac troponin assays in patients admitted with suspected acute coronary syndrome. Clinical Chemistry and Laboratory Medicine. 729-739.
- (2023). Growth Differentiation Factor 15: A Prognostic Marker in Patients with Acute Chest Pain without Acute Myocardial Infarction. Clinical Chemistry. 649-660.
- (2023). Cardiac troponin measurement at the point of care: educational recommendations on analytical and clinical aspects by the IFCC Committee on Clinical Applications of Cardiac Bio-Markers (IFCC C-CB). Clinical Chemistry and Laboratory Medicine. 989-998.
- (2023). Antibody-mediated interferences affecting cardiac troponin assays: recommendations from the IFCC Committee on Clinical Applications of Cardiac Biomarkers. Clinical Chemistry and Laboratory Medicine. 1411-1419.
- (2022). Predictors of long-term symptom burden and quality of life in patients hospitalised with chest pain: a prospective observational study. BMJ Open. 1-10.
- (2022). Implementing screening for myocardial injury in non-cardiac surgery: perspectives of an ad-hoc interdisciplinary expert group. Scandinavian Cardiovascular Journal. 31-39.
- (2022). Association between symptoms and risk of non-ST segment elevation myocardial infarction according to age and sex in patients admitted to the emergency department with suspected acute coronary syndrome: a single-centre retrospective cohort study. BMJ Open. 1-12.
- (2022). Analytical considerations in deriving 99th percentile upper reference limits for high-sensitivity cardiac troponin assays: Educational recommendations from the IFCC committee on clinical application of cardiac bio-markers. Clinical Chemistry. 1022-1030.
- (2022). Adding stress biomarkers to high-sensitivity cardiac troponin for rapid non-ST-elevation myocardial infarction rule-out protocols. European Heart Journal: Acute Cardiovascular Care. 201-212.
- (2021). The association between serum high-sensitivity cardiac troponin T and acute myocardial infarction in patients with suspected chronic coronary syndrome is modified by body mass index. International Journal of Cardiology: Cardiovascular Risk and Prevention (IJCCRP).
- (2021). Regular consumption of cod liver oil is associated with reduced basal and exercise-induced C-reactive protein levels; a prospective observational trial: A NEEDED (The North Sea Race Endurance Exercise Study) 2014 sub-study. Journal of the International Society of Sports Nutrition (JISSN). 1-10.
- (2021). Quality benchmarking of smartphone laboratory medicine applications: Comparison of laboratory medicine specialists' and non-laboratory medicine professionals' evaluation. Clinical Chemistry and Laboratory Medicine. 693-699.
- (2021). How Well Do Laboratories Adhere to Recommended Guidelines for Cardiac Biomarkers Management in Europe? The CArdiac MARker Guideline Uptake in Europe (CAMARGUE) Study of the European Federation of Laboratory Medicine Task Group on Cardiac Markers. Clinical Chemistry. 1144-1152.
- (2021). Diagnostic performance of novel troponin algorithms for the rule-out of non-ST-elevation acute coronary syndrome. Clinical Chemistry. 291-302.
- (2021). Determinants of interindividual variation in exercise-induced cardiac troponin I levels. Journal of the American Heart Association (JAHA). 1-14.
- (2021). Clinical risk scores identify more patients at risk for cardiovascular events within 30 days as compared to standard ACS risk criteria: The WESTCOR study. European Heart Journal: Acute Cardiovascular Care. 287-301.
- (2021). Biomarker Testing Considerations in the Evaluation and Management of Patients With Heart Failure: Perspectives From the International Federation of Clinical Chemistry and Laboratory Medicine Committee. Journal of Cardiac Failure. 1456-1461.
- (2021). Biological variation, reference change values and index of individuality of GDF-15. Clinical Chemistry and Laboratory Medicine. 1-4.
- (2021). Biological variation of cardiac myosin-binding protein C in healthy individuals. Clinical Chemistry and Laboratory Medicine. 8 sider.
- (2020). Update on current practice in laboratory medicine in respect of natriuretic peptide testing for heart failure diagnosis and management in Europe. The CARdiac MArker guideline Uptake in Europe (CARMAGUE) study. Clinica Chimica Acta. 59-66.
- (2020). Systemic Cardiac Troponin T Associated With Incident Atrial Fibrillation Among Patients With Suspected Stable Angina Pectoris. American Journal of Cardiology.
- (2020). Lot-to-lot variation for commercial high-sensitivity cardiac troponin: Can we realistically report down to the assay's limit of detection? Clinical Chemistry. 1146-1149.
- (2020). How well do laboratories adhere to recommended guidelines for dyslipidaemia management in Europe? The CArdiac MARker Guideline Uptake in Europe (CAMARGUE) study. Clinica Chimica Acta. 267-272.
- (2020). High-Sensitivity Cardiac Troponin I and T Response Following Strenuous Activity is Attenuated by Smokeless Tobacco: NEEDED (North Sea Race Endurance Exercise Study) 2014. Journal of the American Heart Association (JAHA). 14 sider.
- (2020). Gastric bypass surgery is associated with reduced subclinical myocardial injury and greater activation of the cardiac natriuretic peptide system than lifestyle intervention. Clinical Biochemistry. 36-44.
- (2020). Endurance exercise training volume is not associated with progression of coronary artery calcification. Scandinavian Journal of Medicine & Science in Sports. 1024-1032.
- (2020). Duration of elevated heart rate Is an important predictor of exercise-induced troponin elevation. Journal of the American Heart Association (JAHA). 1-19.
- (2020). Cardiac Troponin Assays With Improved Analytical Quality: A Trade‐Off Between Enhanced Diagnostic Performance and Reduced Long‐Term Prognostic Value. Journal of the American Heart Association (JAHA). 23 sider.
- (2019). Race duration and blood pressure are major predictors of exercise-induced cardiac troponin elevation. International Journal of Cardiology. 1-8.
- (2019). Physical activity, exercise and cardiac troponins: Clinical implications. Progress in cardiovascular diseases. 108-115.
- (2019). Occult obstructive coronary artery disease is associated with prolonged cardiac troponin elevation following strenuous exercise. European Journal of Preventive Cardiology (EJPC). 1-10.
- (2019). Impact of different preanalytical conditions on results of lupus anticoagulant tests. International Journal of Laboratory Hematology (IJLH). 745-753.
- (2019). Handling of hemolyzed serum samples in clinical chemistry laboratories: The Nordic hemolysis project. Clinical Chemistry and Laboratory Medicine. 1699-1711.
- (2019). Aiming toWards Evidence baSed inTerpretation of Cardiac biOmarkers in patients pResenting with chest pain-the WESTCOR study: study design. Scandinavian Cardiovascular Journal. 280-285.
- (2018). Usefulness of higher levels of cardiac troponin T in patients with stable angina pectoris to predict risk of acute myocardial infarction. American Journal of Cardiology. 1142-1147.
- (2018). The copeptin response after physical activity is not associated with cardiac biomarkers or asymptomatic coronary artery disease: The North Sea Race Endurance Exercise Study (NEEDED) 2013. Clinical Biochemistry. 8-12.
- (2018). The cardiac troponin response following physical exercise in relation to biomarker criteria for acute myocardial infarction; the North Sea Race Endurance Exercise Study (NEEDED) 2013. Clinica Chimica Acta. 155-159.
- (2017). Within-day biological variation and hour-to-hour reference change values for hematological parameters. Clinical Chemistry and Laboratory Medicine. 1013-1024.
- (2017). Could accreditation bodies facilitate the implementation of medical guidelines in laboratories? Clinical Chemistry and Laboratory Medicine. 806-808.
- (2017). Are Heart Failure Management Recommendations and Guidelines Followed in Laboratory Medicine in Europe and North America? The Cardiac Marker Guideline Uptake in Europe (CARMAGUE) Study. The Journal of Applied Laboratory Medicine (JALM). 483-493.
- (2017). A survey of patients' views from eight European countries of interpretive support from Specialists in Laboratory Medicine. Clinical Chemistry and Laboratory Medicine. 1496-1500.
- (2016). The variation in high sensitive cardiac troponin concentration during haemodialysis treatment is not similar to the biological variation observed in stable end stage renal disease patients. Scandinavian Journal of Clinical and Laboratory Investigation. 645-652.
- (2016). Analytical bias exceeding desirable quality goal in 4 out of 5 common immunoassays: Results of a native single serum sample external quality assessment program for cobalamin, folate, ferritin, thyroid-stimulating hormone, and free t4 analyses. Clinical Chemistry. 1255-1263.
- (2014). Weekly and 90-minute biological variations in cardiac troponin T and cardiac troponin I in hemodialysis patients and healthy controls. Clinical Chemistry. 838-847.
- (2014). The quality of laboratory aspects of troponin testing in clinical practice guidelines and consensus documents needs to be improved. Clinica Chimica Acta. 58-61.
- (2013). PSA-måling og prostatakreft – overdiagnostisering og overbehandling? Tidsskrift for Den norske legeforening. 1711-1716.
- (2013). Nasjonale anbefalinger for tolkning av troponinverdier ved diagnostikk av akutt hjerteinfarkt. Tidsskrift for Den norske legeforening.
- (2013). Critical review of laboratory investigations in clinical practice guidelines: proposals for the description of investigation. Clinical Chemistry and Laboratory Medicine. 1217-1226.
- (2012). Reflective testing: adding value to laboratory testing. Clinical Chemistry and Laboratory Medicine. 1249-1252.
- (2012). How do laboratory specialists advise clinicians concerning the use and interpretation of renal tests? Scandinavian Journal of Clinical and Laboratory Investigation. 143-151.
- (2011). Laboratory investigation and follow-up of chronic kidney disease stage 3 in primary care. Clinica Chimica Acta. 1138-1142.
- (2010). Monitoring renal function in children with Fabry disease: comparisons of measured and creatinine-based estimated glomerular filtration rate. Nephrology, Dialysis and Transplantation. 1507-1513.
- (2010). Diagnosing microalbuminuria and consequences for the drug treatment of patients with type 2 diabetes: A European survey in primary care. Diabetes Research and Clinical Practice. 103-109.
- (2009). Validation of the Hemo_Control instrument for determination of B-haemoglobin concentration in primary health care. Scandinavian Journal of Clinical and Laboratory Investigation. 817-821.
- (2009). Monitoring renal Function in Fabry children: comparisons of measured and creatinine-based estimated Glomerular Filtration Rate. Nephrology, Dialysis and Transplantation. 7 sider.
- (2023). Cardiac Troponin Reporting in Children and Young Adults: Time to Change Clinical Practice. Circulation. 17-19.
- (2019). The rise and fall of the 99th percentile decision limit for cardiac troponins? International Journal of Cardiology. 25-26.
- (2019). Cardiac troponin increase after endurance exercise: A new marker of cardiovascular risk? Circulation. 815-818.
- (2010). Can changes in troponin results be useful in diagnosing myocardial infarction? Clinical Chemistry. 1047-1049.
- (2013). Week-to-Week Biological Variation in the N-terminal Prohormone of Brain Natriuretic Peptide in Hemodialysis Patients and Healthy Individuals. Clinical Chemistry. 1813-1814.
- (2023). Week-to-week within-subject and between-subject biological variation of copeptin. Clinical Chemistry and Laboratory Medicine. e29-e33.
- (2021). Impact of different sampling and storage procedures on stability of acid/base parameters in venous blood samples. Clinical Chemistry and Laboratory Medicine. E370-E373.
- (2019). How does the analytical quality of the high-sensitivity cardiac troponin T assay affect the ESC rule out algorithm for NSTEMI? Clinical Chemistry. 494-496.
- (2011). Use and Interpretation of Urinary Albumin and Estimated Glomerular Filtration Rate Findings in Primary Health Care.
- (2009). Monitoring renal Function in Fabry children; estimated or measured glomerular Filtration rate? Molecular Genetics and Metabolism. 74-75.
- (2022). Erratum to ‘The association between serum high-sensitivity cardiac troponin T and acute myocardial infarction in patients with suspected chronic coronary syndrome is modified by body mass index☆,☆☆’ International Journal of Cardiology Cardiovascular Risk and Prevention. Volume 11, December 2021, 200,109 (International Journal of Cardiology Cardiovascular Risk and Prevention (2021) 11, (S2772487521000118), (10.1016/j.ijcrp.2021.200109)). International Journal of Cardiology: Cardiovascular Risk and Prevention (IJCCRP).
- (2024). Lower Limits for Reporting High-Sensitivity Cardiac Troponin Assays and Impact of Analytical Performance on Patient Misclassification. Clinical Chemistry. 497-505.
- (2023). Single Troponin Measurement to Rule Out Myocardial Infarction: JACC Review Topic of the Week. Journal of the American College of Cardiology. 60-69.
- (2023). Point-of-care high-sensitivity troponin assays: Advancements, clinical applications, and implementation considerations. Journal of Laboratory and Precision Medicine.
- (2021). Biological variation of secretoneurin; a novel cardiovascular biomarker implicated in arrhythmogenesis. Clinical Biochemistry. 74-77.
- (2020). Quantifying atherogenic lipoproteins for lipid-lowering strategies: Consensus-based recommendations from EAS and EFLM. Atherosclerosis. 46-61.
- (2020). Analytical performance of cardiac troponin assays – Current status and future needs. Clinica Chimica Acta. 149-155.
- (2016). Why are clinical practice guidelines not followed?: The European Federation of Clinical Chemistry and Laboratory Medicine and European Union of Medical Specialists joint working group on Guidelines. Clinical Chemistry and Laboratory Medicine. 1133-1139.
- (2016). How well do laboratories adhere to recommended clinical guidelines for the management of myocardial infarction: The cardiac marker guidelines uptake in Europe study (carmague). Clinical Chemistry. 1264-1271.
- (2014). How to conduct External Quality Assessment Schemes for the pre-analytical phase? Biochemia Medica. 114-122.
- (2012). Self-monitoring of blood glucose in patients with diabetes who do not use insulinuare guidelines evidence-based? Diabetic Medicine. 1226-1236.
- (2009). Evaluation of prescription and interpretation of microalbuminuria by general practitioners. Annales de Biologie Clinique. 47-53.
- (2009). Current Issues in Measurement and Reporting of Urinary Albumin Excretion. Clinical Chemistry. 24-38.
- (2023). Aiming toWards Evidence baSed inTerpretation of Cardiac biOmarkers in patients pResenting with chest pain using Point of Care Testing (WESTCOR- POC): study design. Scandinavian Cardiovascular Journal.
- (2013). Varsling av sterkt avvikende analyseresultater til rekvirenter utenfor sykehus. Tidsskrift for Den norske legeforening.
Se fullstendig oversikt over publikasjoner i CRIStin.
10 most relevant publications:
1. Adding stress biomarkers to high sensitivity cardiac troponin for rapid NSTEMI rule-out protocols. Ingar Ziad Restan, Ana Yufera Sanchez, Ole-Thomas Steiro, Pedro Lopez-Ayala, Hilde L. Tjora, Jørund Langørgen, Torbjørn Omland, Jasper Boeddinghaus, Thomas Nestelberger, Luca Koechlin, Paul Collinson, Rune Bjørneklett, Kjell Vikenes, Heidi Strand, Øyvind Skadberg, Øistein R. Mjelva, Alf Inge Larsen, Vernon V. S. Bonarjee, Christian Mueller, Kristin M. Aakre. Eur Heart J Acute Cardiovasc Care. 2022 Jan 13:zuab124. doi: 10.1093/ehjacc/zuab124.
2. Diagnostic performance of novel troponin algorithms for the rule-out of Non ST elevation acute coronary syndrome. Hilde L Tjora, Ole-Thomas Steiro, Jørund Langørgen, Rune Bjørneklett, Øyvind Skadberg, Vernon V S Bonarjee, Øistein R Mjelva, Paul Collinson, Torbjørn Omland, Kjell Vikenes, Kristin M Aakre. Clin Chem. 2021 Dec 13:hvab225. doi: 10.1093/clinchem/hvab225.
3. Clinical risk scores identify more patients at risk for cardiovascular events within 30 days as compared to standard ACS risk criteria: The WESTCOR study. Ole-Thomas Steiro, Hilde L Tjora, Jørund Langørgen, Rune Bjørneklett, Ottar K Nygård, Øyvind Skadberg, Vernon V S Bonarjee, Bertil Lindahl, Torbjørn Omland, Kjell Vikenes, Kristin M Aakre. Eur Heart J Acute Cardiovasc Care. 2021 May 11;10(3):287-301. doi: 10.1093/ehjacc/zuaa016
4. Cardiac troponin assays with improved analytical quality – a trade-off between enhanced diagnostic performance and reduced long-term prognostic value. Hilde L Tjora, Ole-Thomas Steiro, Jørund Langørgen, Rune Bjørneklett, Ottar K Nygård, Øyvind Skadberg, Vernon V S Bonarjee, Paul Collinson, Torbjørn Omland, Kjell Vikenes, Kristin M Aakre. J Am Heart Assoc. 2020 Dec;9(23):e017465.
5. Growth differentiation factor 15: a prognostic marker in patients with acute chest pain without acute myocardial infarction. Gard MS Myrmel, Ole-Thomas Steiro, Hilde L Tjora, Jørund Langørgen, Rune Bjørneklett, Øyvind Skadberg, Vernon VS Bonarjee, Øistein R Mjelva, Eva KR Pedersen, Kjell Vikenes, Torbjørn Omland, Kristin M Aakre MD. Accepted for publication in Clin Chem, January 2023.
6. How does the analytical quality of the high sensitivity cardiac troponin T assay affect the ESC rule out algorithm for NSTEMI? Kristin Haagensen, Paul Collinson, Arne Åsberg and Kristin M Aakre. Clin Chem, 2019 Mar;65(3):494-496
7. Analytical bias exceeding desirable quality goal in four out of five common immunoassays: Results of a native single serum sample EQA program for cobalamin, folate, ferritin, TSH and free T4 analyses. Gunn B B Kristensen, Pål Rustad, Jens P Berg and Kristin M Aakre. Clin Chem 2016 Sep;62(9):1255-63.
8. Editorial: Cardiac Troponin Increase after Endurance Exercise: A New Marker of Cardiovascular Risk? Torbjørn Omland and Kristin Moberg Aakre. Circulation, 2019 Sep 9;140(10):815-818
9. Consensus paper: Analytical Considerations in Deriving 99th Percentile Upper Reference Limits for High-Sensitivity Cardiac Troponin Assays: Educational Recommendations from the IFCC Committee on Clinical Application of Cardiac Bio-Markers. Kristin M Aakre, Amy K Saenger, Rick Body, Paul Collinson, Ola Hammarsten, Allan S. Jaffe, Pete Kavsak, Torbjørn Omland, Jordi Ordonez-Lianos, Fred S Apple. Clin Chem. 2022 Jul 27;68(8):1022-1030.
10. Review: Physical Activity, Exercise and Cardiac Troponins: Clinical Implications. Kristin M. Aakre and Torbjørn Omland. Prog Cardiovasc Dis, January 2019. https://doi.org/10.1016/j.pcad.2019.02.005
2023-
The WESTCOR-POC study, PI, Western Norway Regional Health Authority
2019-
The Bergen Atherosclerosis and Cardiac bIOmarker (BACIO) Study, utility of cardiac biomarkers in acute chest pain, Co-PI, Trond Mohn Foundation, Western Norway Regional Health Authority
2018-
Biological variation of cardiac and endocrine biomarkers, PI, Haukeland University Hospital, Kings College, University of Oslo, Western Norway Regional Health Authority
2015-
Aiming towards evidence based interpretation of cardiac biomarkers in patients presenting with chest pain (the WESTCOR-study), PI, Western Norway Regional Health Authority
2012-2016
EQA for detecting analytical bias for five common immunoassays, analytical quality spesifications, PI, The Norwegain Clinical Chemistry EQA program
2010-2016
Biological variation of cardiac biomarkers in ESRD patients and healthy controls, PI, Haukeland University Hospital