Quantitative Point-of-Care Troponin I in Emergency Department in Comparison With Troponin I in Central Laboratory

Many patients may present simultaneously in emergency departments. We must ensure that patients are treated in the order of their clinical urgency and that the treatment is appropriate and timely. Rapid cardiac marker testing may aid in early detection of acute coronary syndromes. It is almost impossible for laboratories to deliver cardiac biomarker results in less than 30 minutes, using serum- or plasma-based assays. Use of plasma for measurement of cardiac biomarkers elimi- nates the clotting process involved in producing serum and therefore reduces the overall turnaround time for biomarker testing. Point-of-care devices allow cardiac troponin I testing using anticoagulated whole blood specimens at the site of patient care delivery. Elimination of transport and centrifugation can reduce the overall turnaround time to less than 30 minutes. We compared the performance of a critical point-of-care device PathFast (Mitsubishi, Kagaku Iatron, Inc, Chiba, Japan) with a core labo- ratory Liaison analyzer (DiaSorin, Saluggia, Italy) for troponin I determi- nation. Both methods are chemiluminiscent immunoassays. Thirty-one consecutive patients from the emergency department presenting with chest pain were included in this study. The results obtained with PathFast correlated very well with those obtained in the core laboratory. Optimum sensitivity and specificity of the PathFast cardiac troponin I were dem- onstrated at a cutoff of 0.1 Kg/L (100% sensitivity and 100% specificity). A significant decrease in overall turnaround time was achieved with the PathFast (20 T 5v s 104T 33 minutes, P G 0.001).