A nearly High Sens point-of-care Troponin: potential equity for rural hospitals?

Posted on by

Pickering JW, Young JM, George PM, et al. Validity of a Novel Point-of-Care Troponin Assay for Single-Test Rule-Out of Acute Myocardial Infarction. JAMA Cardiol. Published online October 17, 2018. doi:10.1001/jamacardio.2018.3368

Second troponin paper for the day:

A first look at a new POC assay from Abbott by a group well known for their work in chest pain assessment. This preliminary study performed in Christchurch ED (urban population) shows a single test (used in a laboratory) on presentation (that takes 15minutes to run) effectively excludes Type 1 myocardial infarction in low-risk patients – with the same Sens/NPV as a laboratory based . Need to wait to see real world performance but promising for rural GP and hospitals reliant on point-of-care troponin when assessing chest pain. Not calling it high-sens yet… Semantics

Open access


This entry was posted in Hot off the press, Papers of interest and tagged , , , by Rory. Bookmark the permalink.

2 thoughts on “A nearly High Sens point-of-care Troponin: potential equity for rural hospitals?

  1. The number of false negatives w POC hsTnT currently, makes it impossible to exclude NSTEMI. It is notoriously unreliable and I do not trust it.
    I hope this test is better and the strips have a longer shelf life

    • Welcome Fiona! Thanks for visiting/reading and engaging.

      POC-cTn use is certainly tricky! Just to be clear there is no currently available high sensitivity point-of-care troponin on the market. They are also very careful not to call this assay high-sensitivity yet… This new (as yet unreleased) assay performed as well as a laboratory/mainframe high-sensitivity assay in controlled laboratory conditions.

      I think you are probably using a qualitative assay – is that right?. These are neither sensitive nor specific (despite the label hsTNT) and no longer recommended for use in clinical practice. Quantative assays like the radiometer AQT-90 or Abbott I-stat (most commonly used assay in rural NZ) are more suitable.

      Sørensen JT, Terkelsen CJ, Steengaard C, Lassen JF, Trautner S, Christensen EF, et al. Prehospital troponin T testing in the diagnosis and triage of patients with suspected acute myocardial infarction. Am J Cardiol. 2011; 107 1436–40.

      Schuchert A, Hamm C, Scholz J, et al. Prehospital testing for troponin T in patients with suspected acute myocardial infarction. Am Heart J. 1999; 138 45–8.

Leave a Reply

Your email address will not be published. Required fields are marked *

* *

This site uses Akismet to reduce spam. Learn how your comment data is processed.