Cardiac biomarkers by point-of-care testing – back to the future?
The measurement of the cardiac troponins (cTn), cardiac troponin T (cTnT) and cardiac troponin I (cTnI) are integral to the management of patients with suspected acute coronary syndromes (ACS). Patients without clear electrocardiographic evidence of myocardial infarction require measurement of cTnT...
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| Format: | Article |
| Language: | English |
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De Gruyter
2020-04-01
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| Series: | Journal of Laboratory Medicine |
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| Online Access: | https://doi.org/10.1515/labmed-2019-0180 |
| _version_ | 1818576552457142272 |
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| author | Collinson Paul |
| author_facet | Collinson Paul |
| author_sort | Collinson Paul |
| collection | DOAJ |
| description | The measurement of the cardiac troponins (cTn), cardiac troponin T (cTnT) and cardiac troponin I (cTnI) are integral to the management of patients with suspected acute coronary syndromes (ACS). Patients without clear electrocardiographic evidence of myocardial infarction require measurement of cTnT or cTnI. It therefore follows that a rapid turnaround time (TAT) combined with the immediacy of results return which is achieved by point-of-care testing (POCT) offers a substantial clinical benefit. Rapid results return plus immediate decision-making should translate into improved patient flow and improved therapeutic decision-making. The development of high sensitivity troponin assays offer significant clinical advantages. Diagnostic algorithms have been devised utilising very low cut-offs at first presentation and rapid sequential measurements based on admission and 3 h sampling, most recently with admission and 1 h sampling. Such troponin algorithms would be even more ideally suited to point-of-care testing as the TAT achieved by the diagnostic laboratory of typically 60 min corresponds to the sampling interval required by the clinician using the algorithm. However, the limits of detection and analytical imprecision required to utilise these algorithms is not yet met by any easy-to-use POCT systems. |
| first_indexed | 2024-12-16T06:15:50Z |
| format | Article |
| id | doaj.art-5104de0cdf3d4af38d90da212d60eb3f |
| institution | Directory Open Access Journal |
| issn | 2567-9430 2567-9449 |
| language | English |
| last_indexed | 2024-12-16T06:15:50Z |
| publishDate | 2020-04-01 |
| publisher | De Gruyter |
| record_format | Article |
| series | Journal of Laboratory Medicine |
| spelling | doaj.art-5104de0cdf3d4af38d90da212d60eb3f2022-12-21T22:41:16ZengDe GruyterJournal of Laboratory Medicine2567-94302567-94492020-04-01442899510.1515/labmed-2019-0180Cardiac biomarkers by point-of-care testing – back to the future?Collinson Paul0Departments of Clinical Blood Sciences and Cardiology, St George’s University Hospitals NHS Foundation Trust and St George’s University of London, Cranmer Terrace London SW17 0QT, UKThe measurement of the cardiac troponins (cTn), cardiac troponin T (cTnT) and cardiac troponin I (cTnI) are integral to the management of patients with suspected acute coronary syndromes (ACS). Patients without clear electrocardiographic evidence of myocardial infarction require measurement of cTnT or cTnI. It therefore follows that a rapid turnaround time (TAT) combined with the immediacy of results return which is achieved by point-of-care testing (POCT) offers a substantial clinical benefit. Rapid results return plus immediate decision-making should translate into improved patient flow and improved therapeutic decision-making. The development of high sensitivity troponin assays offer significant clinical advantages. Diagnostic algorithms have been devised utilising very low cut-offs at first presentation and rapid sequential measurements based on admission and 3 h sampling, most recently with admission and 1 h sampling. Such troponin algorithms would be even more ideally suited to point-of-care testing as the TAT achieved by the diagnostic laboratory of typically 60 min corresponds to the sampling interval required by the clinician using the algorithm. However, the limits of detection and analytical imprecision required to utilise these algorithms is not yet met by any easy-to-use POCT systems.https://doi.org/10.1515/labmed-2019-0180analytical performancecardiac troponin icardiac troponin tmyocardial infarctionpoint-of-care testing |
| spellingShingle | Collinson Paul Cardiac biomarkers by point-of-care testing – back to the future? Journal of Laboratory Medicine analytical performance cardiac troponin i cardiac troponin t myocardial infarction point-of-care testing |
| title | Cardiac biomarkers by point-of-care testing – back to the future? |
| title_full | Cardiac biomarkers by point-of-care testing – back to the future? |
| title_fullStr | Cardiac biomarkers by point-of-care testing – back to the future? |
| title_full_unstemmed | Cardiac biomarkers by point-of-care testing – back to the future? |
| title_short | Cardiac biomarkers by point-of-care testing – back to the future? |
| title_sort | cardiac biomarkers by point of care testing back to the future |
| topic | analytical performance cardiac troponin i cardiac troponin t myocardial infarction point-of-care testing |
| url | https://doi.org/10.1515/labmed-2019-0180 |
| work_keys_str_mv | AT collinsonpaul cardiacbiomarkersbypointofcaretestingbacktothefuture |