Point-of-care testing with high-sensitivity cardiac troponin assays: the challenges and opportunities

被引:44
作者
Cullen, Louise [1 ]
Collinson, Paul O. [2 ,3 ]
Giannitsis, Evangelos [4 ]
机构
[1] Royal Brisbane & Womens Hosp, Emergency & Trauma Ctr, Herston, Qld, Australia
[2] Georges Univ London, Dept Clin Blood Sci, London, England
[3] Georges Univ London, Dept Cardiol, London, England
[4] Univ Hosp Heidelberg, Med Dept 3, Heidelberg, Germany
关键词
emergency department; assessment; MYOCARDIAL-INFARCTION; ANALYTICAL PERFORMANCE; RANDOMIZED ASSESSMENT; UNIVERSAL DEFINITION; EUROPEAN-SOCIETY; RATPAC TRIAL; PANEL ASSAY; RULE-OUT; ALGORITHM; IMPLEMENTATION;
D O I
10.1136/emermed-2021-211907
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Methods to improve the safety, accuracy and efficiency of assessment of patients with suspected acute coronary symptoms have occupied decades of study and have supported significant changes in clinical practice. Much of the progress is reliant on results of laboratory-based high-sensitivity cardiac troponin assays that can detect low concentrations with high precision. Until recently, point-of-care (POC) platforms were unable to perform with similar analytical precision as laboratory-based assays, and recommendations for their use in accelerated assessment strategies for patients with suspected acute coronary syndrome has been limited. As POC assays can provide troponin results within 20 min, and can be used proximate to patient care, improvements in the efficiency of assessment of patients with suspected acute coronary syndrome is possible, particularly with new high-sensitivity assays.
引用
收藏
页码:861 / 866
页数:6
相关论文
共 44 条
[1]   Acute rule-out of non-ST-segment elevation acute coronary syndrome in the (pre)hospital setting by HEART score assessment and a single point-of-care troponin: rationale and design of the ARTICA randomised trial [J].
Aarts, Goaris W. A. ;
Camaro, Cyril ;
van Geuns, Robert-Jan ;
Cramer, Etienne ;
van Kimmenade, Roland R. J. ;
Damman, P. ;
van Grunsven, Pierre M. ;
Adang, Eddy ;
Giesen, Paul ;
Rutten, Martijn ;
Ouwendijk, Olaf ;
Gomes, Marc E. R. ;
van Royen, Niels .
BMJ OPEN, 2020, 10 (02)
[2]   Diagnostic Performance of Prehospital Point-of-Care Troponin Tests to Rule Out Acute Myocardial Infarction: A Systematic Review [J].
Alghamdi, Abdulrhman ;
Alotaibi, Ahmed ;
Alharbi, Meshal ;
Reynard, Charles ;
Body, Richard .
PREHOSPITAL AND DISASTER MEDICINE, 2020, 35 (05) :567-573
[3]   PRe-hospital Evaluation of Sensitive TrOponin (PRESTO) Study: multicentre prospective diagnostic accuracy study protocol [J].
Alghamdi, Abdulrhman ;
Cook, Eloise ;
Carlton, Edward ;
Siriwardena, Aloysius ;
Hann, Mark ;
Thompson, Alexander ;
Foulkes, Angela ;
Phillips, John ;
Cooper, Jamie ;
Bell, Steve ;
Kirby, Kim ;
Rosser, Andy ;
Body, Richard .
BMJ OPEN, 2019, 9 (10)
[4]   Myocardial infarction redefined -: A consensus Document of the Joint European Society of Cardiology/American College of Cardiology Committee for the Redefinition of Myocardial Infarction [J].
Alpert, JS ;
Antman, E ;
Apple, F ;
Armstrong, PW ;
Bassand, JP ;
de Luna, AB ;
Beller, G ;
Breithardt, G ;
Chaitman, BR ;
Clemmensen, P ;
Falk, E ;
Fishbein, MC ;
Galvani, M ;
Garson, A ;
Grines, C ;
Hamm, C ;
Jaffe, A ;
Katus, H ;
Kjekshus, J ;
Klein, W ;
Klootwijk, P ;
Lenfant, C ;
Levy, D ;
Levy, RI ;
Luepker, R ;
Marcus, F ;
Näslund, U ;
Ohman, M ;
Pahlm, O ;
Poole-Wilson, P ;
Popp, R ;
Alto, P ;
Pyörälä, K ;
Ravkilde, J ;
Rehnquist, N ;
Roberts, W ;
Roberts, R ;
Roelandt, J ;
Rydén, L ;
Sans, S ;
Simoons, ML ;
Thygesen, K ;
Tunstall-Pedoe, H ;
Underwood, R ;
Uretsky, BF ;
Van de Werf, F ;
Voipio-Pulkki, LM ;
Wagner, G ;
Wallentin, L ;
Wijns, W .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2000, 36 (03) :959-969
[5]   Global Adoption of High-Sensitivity Cardiac Troponins and the Universal Definition of Myocardial Infarction [J].
Anand, Atul ;
Shah, Anoop S., V ;
Beshiri, Agim ;
Jaffe, Allan S. ;
Mills, Nicholas L. .
CLINICAL CHEMISTRY, 2019, 65 (03) :484-489
[6]   Acute Myocardial Infarction [J].
Anderson, Jeffrey L. ;
Morrow, David A. .
NEW ENGLAND JOURNAL OF MEDICINE, 2017, 376 (21) :2053-2064
[7]  
[Anonymous], 1979, Circulation, V59, P607
[8]   Determination of sex-specific 99th percentile upper reference limits for a point of care high sensitivity cardiac troponin I assay [J].
Apple, Fred S. ;
Schulz, Karen ;
Schmidt, Christian W. ;
van Domburg, Trees S. Y. ;
Fonville, Judith M. ;
de Theije, Femke K. .
CLINICAL CHEMISTRY AND LABORATORY MEDICINE, 2021, 59 (09) :1574-1578
[9]   Decreased patient charges following implementation of point-of-care cardiac troponin monitoring in acute coronary syndrome patients in a community hospital cardiology unit [J].
Apple, Fred S. ;
Chung, Adrine Y. ;
Kogut, Mary Ellen ;
Bubany, Susan ;
Murakami, MaryAnn M. .
CLINICA CHIMICA ACTA, 2006, 370 (1-2) :191-195
[10]   Analytical Characteristics of High-Sensitivity Cardiac Troponin Assays [J].
Apple, Fred S. ;
Collinson, Paul O. .
CLINICAL CHEMISTRY, 2012, 58 (01) :54-61