Comparison of new point-of-care troponin assay with high sensitivity troponin in diagnosing myocardial infarction
Objectives: The aim of this study is to compare a new improved point of care cardiac troponin assay (new POC-cTnI) with 1. its predecessor (old POC-cTnI) and 2. a high sensitivity assay (hs-cTnI) for the diagnosis of acute myocardial infarction (AMI) and for major adverse cardiac events (MACE) by 30...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Journal Article |
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Elsevier Ireland Ltd
2014
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| Online Access: | http://hdl.handle.net/20.500.11937/4174 |
| _version_ | 1848744441460817920 |
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| author | Aldous, S. Mark Richards, A. George, P. Cullen, L. Parsonage, W. Flaws, D. Florkowski, C. Troughton, R. O'Sullivan, J. Reid, Christopher Bannister, L. Than, M. |
| author_facet | Aldous, S. Mark Richards, A. George, P. Cullen, L. Parsonage, W. Flaws, D. Florkowski, C. Troughton, R. O'Sullivan, J. Reid, Christopher Bannister, L. Than, M. |
| author_sort | Aldous, S. |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Objectives: The aim of this study is to compare a new improved point of care cardiac troponin assay (new POC-cTnI) with 1. its predecessor (old POC-cTnI) and 2. a high sensitivity assay (hs-cTnI) for the diagnosis of acute myocardial infarction (AMI) and for major adverse cardiac events (MACE) by 30 days. Methods: This is a single centre observational study, set in Christchurch Hospital, New Zealand. Patients presenting to the emergency department with non-traumatic chest pain underwent blood sampling at 0 h and 2 h post presentation for analysis with the 3 cTnI assays for the outcome of AMI and for analysis using an accelerated diagnostic protocol (ADP-normal 2 h troponins, normal electrocardiograms and Thrombolysis In Myocardial Infarction (TIMI) score of 0 or ≤ 1) for 30 day MACE. Results: Of 962 patients, 220 (22.9%) had AMI. Old POC-cTnI was least sensitive at 70.0% (65.4–73.9%) by 2 h (p < 0.001). New POC-cTnI, sensitivity 93.6% (89.9–96.2%) had similar sensitivity to hs-cTnI, sensitivity 95.0% (91.5–97.3%) (p = 0.508). There were 231 (24.0%) patients with 30 day MACE. When used as part of the ADP, all assays had 100% (98.0–100%) sensitivity using TIMI = 0. Sensitivities of new POC-cTnI ADP, 98.3% (95.4–99.4%), old POC-cTnI, 96.5% (93.2–98.4%) and hs-cTnI, 98.7% (96.0–99.7%) were similar (p = 0.063–0.375) using TIMI ≤ 1. Conclusions: A new POC-cTnI has improved sensitivity for AMI and MACE compared with its predecessor and comparable sensitivity to a high sensitivity assay. Now that sensitivities of the POC assay are improved, the new assay may be a useful alternative to central laboratory assays when rapid turn-around times are not possible. |
| first_indexed | 2025-11-14T06:01:31Z |
| format | Journal Article |
| id | curtin-20.500.11937-4174 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| last_indexed | 2025-11-14T06:01:31Z |
| publishDate | 2014 |
| publisher | Elsevier Ireland Ltd |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-41742017-09-13T14:32:14Z Comparison of new point-of-care troponin assay with high sensitivity troponin in diagnosing myocardial infarction Aldous, S. Mark Richards, A. George, P. Cullen, L. Parsonage, W. Flaws, D. Florkowski, C. Troughton, R. O'Sullivan, J. Reid, Christopher Bannister, L. Than, M. Objectives: The aim of this study is to compare a new improved point of care cardiac troponin assay (new POC-cTnI) with 1. its predecessor (old POC-cTnI) and 2. a high sensitivity assay (hs-cTnI) for the diagnosis of acute myocardial infarction (AMI) and for major adverse cardiac events (MACE) by 30 days. Methods: This is a single centre observational study, set in Christchurch Hospital, New Zealand. Patients presenting to the emergency department with non-traumatic chest pain underwent blood sampling at 0 h and 2 h post presentation for analysis with the 3 cTnI assays for the outcome of AMI and for analysis using an accelerated diagnostic protocol (ADP-normal 2 h troponins, normal electrocardiograms and Thrombolysis In Myocardial Infarction (TIMI) score of 0 or ≤ 1) for 30 day MACE. Results: Of 962 patients, 220 (22.9%) had AMI. Old POC-cTnI was least sensitive at 70.0% (65.4–73.9%) by 2 h (p < 0.001). New POC-cTnI, sensitivity 93.6% (89.9–96.2%) had similar sensitivity to hs-cTnI, sensitivity 95.0% (91.5–97.3%) (p = 0.508). There were 231 (24.0%) patients with 30 day MACE. When used as part of the ADP, all assays had 100% (98.0–100%) sensitivity using TIMI = 0. Sensitivities of new POC-cTnI ADP, 98.3% (95.4–99.4%), old POC-cTnI, 96.5% (93.2–98.4%) and hs-cTnI, 98.7% (96.0–99.7%) were similar (p = 0.063–0.375) using TIMI ≤ 1. Conclusions: A new POC-cTnI has improved sensitivity for AMI and MACE compared with its predecessor and comparable sensitivity to a high sensitivity assay. Now that sensitivities of the POC assay are improved, the new assay may be a useful alternative to central laboratory assays when rapid turn-around times are not possible. 2014 Journal Article http://hdl.handle.net/20.500.11937/4174 10.1016/j.ijcard.2014.09.026 Elsevier Ireland Ltd restricted |
| spellingShingle | Aldous, S. Mark Richards, A. George, P. Cullen, L. Parsonage, W. Flaws, D. Florkowski, C. Troughton, R. O'Sullivan, J. Reid, Christopher Bannister, L. Than, M. Comparison of new point-of-care troponin assay with high sensitivity troponin in diagnosing myocardial infarction |
| title | Comparison of new point-of-care troponin assay with high sensitivity troponin in diagnosing myocardial infarction |
| title_full | Comparison of new point-of-care troponin assay with high sensitivity troponin in diagnosing myocardial infarction |
| title_fullStr | Comparison of new point-of-care troponin assay with high sensitivity troponin in diagnosing myocardial infarction |
| title_full_unstemmed | Comparison of new point-of-care troponin assay with high sensitivity troponin in diagnosing myocardial infarction |
| title_short | Comparison of new point-of-care troponin assay with high sensitivity troponin in diagnosing myocardial infarction |
| title_sort | comparison of new point-of-care troponin assay with high sensitivity troponin in diagnosing myocardial infarction |
| url | http://hdl.handle.net/20.500.11937/4174 |