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
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.