Point-of-Care High-Sensitivity Troponin Use in an ESC-Type Pathway for Assessment of Possible Acute Myocardial Infarction in the Emergency Department

Abstract

This prospective observational study aimed to assess the diagnostic utility of point-of-care (POC) high-sensitivity troponin (hs-cTn) within an ED chest pain pathway. Patients had paired laboratory hs-cTnT and POC hs-cTnI on arrival. Clinical care utilised the hs-cTnT result. Allocation to risk classes was compared between hs-cTnT and POC hs-cTnI. AMI was adjudicated blinded to the POC result. Of 184 patients, 14 (7.6%) had AMI. Twenty-one (11.4%) had AMI ruled out by hs-cTnT and 59 (32.1%) by POC, both with 100% sensitivity. The POC test returned invalid results in 17 patients (8.5%). A POC hs-cTnI assay within a clinical pathway may effectively risk stratify for AMI.