Bedside troponin T testing is not useful for early out-of-hospital diagnosis of myocardial infarction.
BACKGROUND
A new commercially available rapid qualitative bedside immunoassay for cardiac troponin T has been developed. The aim of the study was to investigate whether this new rapid bedside cardiac troponin T assay facilitates diagnosing myocardial infarction in a pre-hospital setting.


METHODS
We evaluated the sensitivity and specificity of the new rapid bedside troponin T assay for myocardial infarction. In 68 patients with acute, central, crushing chest pain, who were strongly suspected of having myocardial infarction, the emergency doctor performed preclinically a bedside cardiac troponin T test. The results were compared with the diagnosis after admission to hospital, using the criteria of the World Health Organization.


RESULTS
The diagnosis of myocardial infarction was confirmed in 16/68 (24%) patients after admission to hospital, but only in 4/16 (25%) patients with myocardial infarction was a positive result observed preclinically with this test. The result was false positive in 1/5 patients (20%).


CONCLUSIONS
In contrast to an excellent specificity (0.98), sensitivity (0.25) of the rapid troponin T assay was poor. Thus, we conclude that this test cannot improve the distinction between myocardial infarction and angina pectoris in a pre-hospital setting.
Gust
R
R
Department of Anaesthesiology, University of Heidelberg, Germany.
Gust
A
A
Böttiger
B W
BW
Böhrer
H
H
Martin
E
E
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D014336:Troponin / Q000032:analysis*; D020107:Troponin T
D015415:Biomarkers; D014336:Troponin; D020107:Troponin T