title: Availability of troponin testing for cardiac patients in New Zealand 2002 to 2011: implications for patient care.
abstract: OBJECTIVE
  For patients presenting with an acute coronary syndrome (ACS), troponin T or I levels are crucial for the diagnosis of myocardial infarction (MI). We investigated troponin tests, analyser types and thresholds used in New Zealand (NZ) from 2002 to 2011.
  
  
  METHODS
  We reviewed troponin tests available at hospitals in NZ which admitted ACS patients and those who had troponin testing in 2002 (n=41), 2007 (n=43) and 2011 (n=43). We also contacted community laboratories and manufacturers.
  
  
  RESULTS
  In 2010-11 there were nine different troponin analysers in 43 hospitals provided by five companies. Troponin T assays were used in 58% of the hospitals and 42% used troponin I as their first-line method. Quoted cutpoints have become more aligned since 2002 and 2007, but are still different from laboratory cutpoints using point of care methods.
  
  
  CONCLUSIONS
  There are differences in troponin tests available across NZ. Test thresholds and units vary, even for the same test, and available diagnostic information cannot always be used to identify a troponin rise and fall. Care is needed when comparing results from different methods and when point of care instruments are used. A coordinated national approach to the development of new biochemical tests, such as troponins, may result in better use of resources and better patient care.
authors.affiliation: Green Lane CVS Service, Level 3, Auckland City Hospital, Grafton, Auckland 1023, New Zealand.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Latif
authors.forename: Chris
authors.initials: C
authors.lastname: Ellis
authors.forename: Alexei
authors.initials: A
authors.lastname: Chataline
authors.forename: Greg
authors.initials: G
authors.lastname: Gamble
authors.forename: Cam
authors.initials: C
authors.lastname: Kyle
authors.forename: Harvey
authors.initials: H
authors.lastname: White
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D019719:Diagnostic Equipment / Q000706:statistics & numerical data*; D006801:Humans; D009520:New Zealand; D018570:Risk Assessment; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D019210:Troponin I; D020107:Troponin T