title: Point-of-Care Testing of Troponin Levels Compared With Automated Laboratory Evaluation: A Reliability Study.
abstract: Traditionally, troponin levels are measured in the blood using an automated laboratory protocol, but the use of a faster technology, the point-of-care (POC) testing of troponin levels, has shown promise in the effective differential diagnosis of cardiac injury. The purpose of this study was to compare the 2 methods. A total of 1567 patients were seen in the emergency department who were tested with both the POC iSTAT troponin and laboratory troponin from a secondary analysis of retrospective data collected between June 2012 and December 2012. The values for laboratory troponin varied between 0 and 30 with a mean and standard deviation of 0.060 ± 0.842 and the values for POC testing varied between 0 and 17.2 with a mean and standard deviation of 0.042 ± 0.492. The Bland-Altman analysis showed a systematic negative bias for the POC values compared with the laboratory troponin values. Lowering the POC cut-off value for troponin to 0.035 yielded 3 out of 4 better validity coefficients compared with those with the suggested manufacturer's cut-off value of 0.08 when predicting the gold standard. The POC troponin can be used to measure troponin level and similar diagnosis if the cut-off value for the POC troponin is lowered to 0.035 instead of the 0.08 suggested manufacturer's cut-off.
authors: West Kendall Baptist Hospital, Miami, Florida (Ms Sardi, Dr Lamoureux, and Ms Phillip-Samuel); and Nursing and Health Sciences Research, Baptist Health South Florida, Miami, Florida, and Boston, Massachusetts (Dr Cohn).
authors: Adacilis Ramirez
authors: AR
authors: Sardi
authors: Julie A
authors: JA
authors: Lamoureux
authors: Tanya M
authors: TM
authors: Cohn
authors: Shirley G
authors: SG
authors: Phillip-Samuel
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D000067716:Point-of-Care Testing; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014336:Troponin / Q000097:blood*
chemical_list: D015415:Biomarkers; D014336:Troponin