Troponin testing for chest pain in primary healthcare: a survey of its use by general practitioners in New Zealand.
OBJECTIVE
Serum troponin is now the preferred biochemical marker for myocardial infarction. The aim of this study was to investigate general practitioner (GP) knowledge and use of serum troponin testing in primary healthcare.


METHODS
We sent a postal survey about troponin testing to all GPs in the Wellington region (n=299) of New Zealand.


RESULTS
Of the 299 surveys sent, 216 replies were received (72%). 54% (n=115) of participants were male and 58% (n=113) in full time practice. 92% were using troponin tests (58% monthly). ECG (79%) and serum troponin (78%) were the tests most commonly used to triage patients with chest pain. GPs had excellent knowledge of false negative scenarios (84% correctly identified false negative if test undertaken within 6 hours) and less knowledge of false positive scenarios (39% answered 'Don't know').


CONCLUSIONS
The majority of GPs use serum troponin tests, and have sufficient knowledge of the test for use in a primary care setting. Most GPs use the tests appropriately, although a small proportion of doctors may defer rapid admission to hospital while waiting for the test result (7%) or manage the patient within general practice (5%) in those patients who have chest pain considered 'possibly' due to myocardial infarction.
Law
Kate
K
Department of Primary Care and General Practice and Medicine, Wellington School of Medicine and Health Sciences, University of Otago, Wellington.
Elley
Raina
R
Tietjens
James
J
Mann
Stewart
S
D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000097:blood* / Q000175:diagnosis; D004562:Electrocardiography / Q000706:statistics & numerical data; D005188:False Negative Reactions; D005189:False Positive Reactions; D005194:Family Practice / Q000706:statistics & numerical data*; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis; D009520:New Zealand; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data; D014336:Troponin / Q000097:blood*
D015415:Biomarkers; D014336:Troponin