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Quantitative Point-of-Care Troponin I in Emergency Department in Comparison With Troponin I in Central Laboratory

Možina, Hugon MD, Msc*; Vukan, Valerija†; Lenart, Katarina Msc†; Skitek, Milan PhD†; Osredkar, Joško PhD†

Point of Care: The Journal of Near-Patient Testing & Technology: March 2010 - Volume 9 - Issue 1 - pp 8-11
doi: 10.1097/POC.0b013e3181d050c0
Original Articles

Many patients may present simultaneously in emergency departments. We must ensure that patients are treated in the order of their clinical urgency and that the treatment is appropriate and timely. Rapid cardiac marker testing may aid in early detection of acute coronary syndromes. It is almost impossible for laboratories to deliver cardiac biomarker results in less than 30 minutes, using serum- or plasma-based assays. Use of plasma for measurement of cardiac biomarkers eliminates the clotting process involved in producing serum and therefore reduces the overall turnaround time for biomarker testing. Point-of-care devices allow cardiac troponin I testing using anticoagulated whole blood specimens at the site of patient care delivery. Elimination of transport and centrifugation can reduce the overall turnaround time to less than 30 minutes.

We compared the performance of a critical point-of-care device PathFast (Mitsubishi, Kagaku Iatron, Inc, Chiba, Japan) with a core laboratory Liaison analyzer (DiaSorin, Saluggia, Italy) for troponin I determination. Both methods are chemiluminiscent immunoassays. Thirty-one consecutive patients from the emergency department presenting with chest pain were included in this study. The results obtained with PathFast correlated very well with those obtained in the core laboratory. Optimum sensitivity and specificity of the PathFast cardiac troponin I were demonstrated at a cutoff of 0.1 μg/L (100% sensitivity and 100% specificity). A significant decrease in overall turnaround time was achieved with the PathFast (20 ± 5 vs 104 ± 33 minutes, P < 0.001).

From the *Medical Emergency Unit, Division of Internal Medicine, and †Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Reprints: Joško Osredkar, PhD, Clinical Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Zaloška 2, 1000 Ljubljana, Slovenia. E-mail: josko.osredkar@kclj.si.

The evaluation of point-of-care testing is a project supported by the grant from the University Medical Centre Ljubljana.

© 2010 Lippincott Williams & Wilkins, Inc.