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Evaluation of the Roche Troponin T Cardiac Reader in an Emergency Department STAT Laboratory: Comparison To The Elecsys Troponin T Method

Lewandrowski, Elizabeth Lee PhD, MPH; Lewandrowski, Kent MD

Peer-Reviewed Articles

The authors report an evaluation of the Roche Cardiac Reader point-of-care troponin T assay (Roche Diagnostics, Indianapolis, IN) in an emergency department STAT laboratory. Overall, the Cardiac Reader showed excellent agreement with the Elecsys troponin T assay (Roche Diagnostics, Indianapolis, IN) (Y = 1.09X + 0.05, r = 0.96) over the range of values from 0.1 ng/ml to 2 ng/ml. The Cardiac Reader agreed with the laboratory-based assay in terms of the diagnostic classification of the patient in 96.2% of cases. Only one of the discordant results (< 1%) could be considered clinically relevant, albeit the discordance would most likely not have occurred on serial testing, as is commonly performed. These data demonstrate that the Roche Cardiac Reader troponin T assay can be performed successfully outside the laboratory in a point-of-care emergency department setting. In contrast to other point-of-care devices for testing of troponin, the Roche Cardiac Reader gives equivalent numeric values to the manufacturers clinical laboratory method. Systems available for troponin I testing at the point of care, and in the central laboratory, typically yield results that correlate, but produce different numeric and cutoff values. This may create issues when comparing emergency department point-of-care test results with serial follow-up laboratory values after patients are admitted to hospital units. Likewise, cutoff values may be different, and this requires careful consideration of the format for reporting the point-of-care test during implementation. In contrast, the Cardiac Reader troponin T system eliminates this problem and, therefore, may be easier to standardize with the clinical laboratory.

From the Massachusetts General Hospital, Department of Pathology (Division of Clinical Laboratories), and Harvard Medical School, Boston, MA, USA.

Address correspondence and reprint requests to Kent Lewandrowski, MD, Massachusetts General Hospital, Fruit Street, Gray 5 Chemistry, Boston, MA 02114 (e-mail: klewandrowski@partners.org).

This study was supported in part by a grant from Roche Diagnostics.

© 2002 Lippincott Williams & Wilkins, Inc.