title: [Evaluation of a rapid qualitative test for cardiac troponin T in clinical diagnosis of patients with acute coronary syndrome].
abstract: OBJECTIVE
  To evaluate the practical performance and the diagnostic power of a rapid, qualitative assay for the detection of cardiac Troponin T (indicated cut-off level: 0.3 ng/ml) in EMS patients presenting with acute myocardial ischemia.
  
  
  METHODS
  145 consecutive patients with non-traumatic chest pain treated by the Mobile Intensive Care Unit team. During phase 1 (73 patients), blood drawn at the emergency site was used to perform a Troponin T rapid assay under defined conditions at the hospital. During phase 2 (72 patients), the rapid assay was already performed at the emergency site.
  
  
  RESULTS
  In phase 1 all tests were performed correctly, whereas 5.6% of the test results had to be declared invalid in phase 2. 17 (11.7%) of the 145 patients showed a positive test result. Analytic sensitivity was 100%, specificity 96.3%. 37 of the 145 patients (median duration of symptoms: 150 minutes) showed a myocardial infarction (MI). Related to the diagnosis of MI diagnostic sensitivity, specificity, positive and negative predictive values were 35.1, 96.3, 76.5, and 81.3%. Mortality in patients with a positive rapid assay was 35.3%, compared to 6.3% in patients with a negative test result (p < 0.001).
  
  
  CONCLUSIONS
  The rapid assay allows the detection of Troponin T in concentrations above the cut-off level. Meticulous observance of the manufacturer's rules is imperative. A single preclinical rapid assay does not allow to exclude a MI. However, the test enables EMS personnel to identify patients who are at increased risk of dying from an acute coronary syndrome in the immediate future.
authors.affiliation: Institut für Anästhesiologie und Operative Intensivmedizin, Klinikum Mannheim gGmbH.
authors.forename: T
authors.initials: T
authors.lastname: Luiz
authors.forename: K
authors.initials: K
authors.lastname: Ellinger
authors.forename: A
authors.initials: A
authors.lastname: Budde
authors.forename: C
authors.initials: C
authors.lastname: Hechler
authors.forename: H
authors.initials: H
authors.lastname: Klar
authors.forename: T
authors.initials: T
authors.lastname: Riester
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D003325:Coronary Care Units; D004632:Emergency Medical Services; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008952:Mobile Health Units; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D011379:Prognosis; D011933:Reagent Kits, Diagnostic; D012680:Sensitivity and Specificity; D014336:Troponin / Q000097:blood*; D020107:Troponin T
chemical_list: D015415:Biomarkers; D011933:Reagent Kits, Diagnostic; D014336:Troponin; D020107:Troponin T
vernacular_title: Evaluierung eines qualitativen Schnelltestes für kardiales Troponin T zur präklinischen Diagnostik bei Patienten mit akutem Koronarsyndrom.