Evaluation of point-of-care test systems using the new definition of myocardial infarction.
OBJECTIVE
To examine the proportion of patients admitted to CCU because of chest pain with a negative quantitative troponin t-test (Cardiac reader; Roche), who despite the negative test, would fulfil the new myocardial infarction criteria. A second aim was to evaluate the clinical utility of troponin I.


METHODS
Troponin T (Cardiac reader; Roche) was measured 12 h after the last chest pain episode. If Troponin T was negative the subjects were included in the study. All included subjects were also examined with troponin I (Stratus CS; Dade Behring) and troponin T at the central laboratory (Elecsys 2010) at the same time. 187 patients were included. CKMB was also measured 6 h after the last chest pain (Stratus CS; Dade Behring).


RESULTS
Fifteen patients (8.0%) fulfilled the criteria of myocardial infarction, despite a negative Troponin T (Cardiac reader; Roche). CKMB measures did not add useful diagnostic information. The sensitivity and specificity were 100% and 95.3%, respectively for troponin I, when 0.2 microg/L was used as cut off level for myocardial infarction.


CONCLUSIONS
In this low risk group, eight percent of the patients with a negative Troponin T (Cardiac reader; Roche) fulfilled the new criteria of myocardial infarction. Troponin I (Stratus CS; Dade Behring) appeared to be a reliable method in this group.
Agewall
Stefan
S
Department of Cardiology, Huddinge University Hospital, Karolinska Institute, Stockholm, Sweden. stefan.agewall@cardiol.hs.sll.se
D000368:Aged; D002624:Chemistry, Clinical / Q000379:methods; D003402:Creatine Kinase / Q000097:blood; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000145:classification / Q000175:diagnosis*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors; D019210:Troponin I / Q000097:blood; D020107:Troponin T / Q000097:blood
D019210:Troponin I; D020107:Troponin T; D003402:Creatine Kinase