Diagnostic evaluation of a high-sensitivity troponin I point-of-care assay
BACKGROUND: Increasing numbers of patients are presenting worldwide to emergency departments with suspected myocardial infarction. The use of point-of-care troponin assays might enable faster decision-making in this high-risk population and reduce the burden on emergency facilities. Here, we evaluat...
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| Main Authors: | , , , , , , , |
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| Format: | Article (Journal) |
| Language: | English |
| Published: |
November 2019
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| In: |
Clinical chemistry
Year: 2019, Volume: 65, Issue: 12, Pages: 1592-1601 |
| ISSN: | 1530-8561 |
| DOI: | 10.1373/clinchem.2019.307405 |
| Online Access: | Verlag, Volltext: https://doi.org/10.1373/clinchem.2019.307405 Verlag, Volltext: http://clinchem.aaccjnls.org/content/65/12/1592 
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| Author Notes: | Nils A. Sörensen, Johannes T. Neumann, Francisco Ojeda, Evangelos Giannitsis, Eberhard Spanuth, Stefan Blankenberg, Dirk Westermann, and Tanja Zeller |
| Summary: | BACKGROUND: Increasing numbers of patients are presenting worldwide to emergency departments with suspected myocardial infarction. The use of point-of-care troponin assays might enable faster decision-making in this high-risk population and reduce the burden on emergency facilities. Here, we evaluate the diagnostic performance of a point-of-care high-sensitivity troponin I assay. - METHODS: We conducted a prospective cohort study including patients presenting to the emergency department with suspected myocardial infarction from July 2013 to July 2016. A diagnostic algorithm for a high-sensitivity troponin I point-of-care assay was developed in a derivation data set with 669 patients and validated in an additional 610 patients. - RESULTS: The derived 0/1 h algorithm for the point-of-care assay consisted of an admission troponin I <4 ng/L and a δ from 0 h to 1 h <3 ng/L for rule out and an admission troponin I ≥90 ng/L or a δ from 0 h to 1 h ≥20 ng/L for rule in of non-ST-elevation myocardial infarction. Application to the validation cohort showed a negative predictive value of 99.7% (95% CI, 98.1%-100.0%) and 48.0% of patients ruled out, whereas 14.6% were ruled in with a positive predictive value of 86.5% (95% CI, 77.6%-92.8%). The diagnostic performance of the point-of-care high-sensitivity assay was highly comparable to guideline-recommended use of a laboratory-based high-sensitivity troponin assay. - CONCLUSIONS: The clinical application of a 0/1 h diagnostic algorithm based on a high-sensitivity troponin I point-of-care assay is safe, and diagnostic performance is comparable to a laboratory-based high-sensitivity troponin I assay. |
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| Item Description: | Gesehen am 14.01.2020 |
| Physical Description: | Online Resource |
| ISSN: | 1530-8561 |
| DOI: | 10.1373/clinchem.2019.307405 |