Startseite Medizin Diagnostic performance of a point of care high-sensitivity cardiac troponin I assay and single measurement evaluation to rule out and rule in acute coronary syndrome
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Diagnostic performance of a point of care high-sensitivity cardiac troponin I assay and single measurement evaluation to rule out and rule in acute coronary syndrome

  • Vincenzo De Iuliis ORCID logo EMAIL logo , Anna Rita Gabriele , Francesca De Santis , Roberta De Rugeriis , Luigi Di Quinzio , Steeve Aloisi , Anna Carla Rosati , Manuela Benvenuto , Donatello Fabiani und Sofia Chiatamone Ranieri
Veröffentlicht/Copyright: 29. April 2024
Clinical Chemistry and Laboratory Medicine (CCLM)
Aus der Zeitschrift Clinical Chemistry and Laboratory Medicine (CCLM) Band 62 Heft 11

Abstract

Objectives

About 10 million individuals in USA presented annually in the emergency department (ED) with chest pain or with signs and symptoms of acute coronary syndrome (ACS). The advent of point of care (POC) devices, able to measure high sensitivity troponin, are a very interesting tool in the ED setting for its rapid turnaround time (<10 min).

Methods

The present study evaluates the diagnostic performance of the Atellica VTLi (Siemens) in real life setting using the clinical data derived from integrated diagnoses of emergency room staff and cardiologist and in comparison with standard laboratory hs-cTnT assay (Cobas 8000, Elecsys, Roche). 966 patients admitted to the emergency department of “G. Mazzini Hospital” in Teramo, Italy, from July 27, 2022, through June 09, 2023, were enrolled.

Results

The diagnostic performance of POC hs-cTnI was evaluated. An appropriate POC hs-cTnI threshold values <4 ng/L supplied a sensitivity and an NPV of 100 % (95 % CI: 99.5–100) in order to achieve rapid rule out for MI through a single measurement at patient presentation in the ED. Furthermore, a derivation POC hs-cTnI concentration >54 ng/L provided a specificity of 97.2 % (95 % CI: 95.9–98.1) and a PPV of 43.5 % (95 % CI: 40.3–46.7) for ruling in MI.

Conclusions

This platform showed comparable diagnostic performance for myocardial infarction to the central laboratory. Our data suggest the possible use of the Atellica VTLi hs-cTnI POC assay either in emergency department of urban medical centre, either in rural hospital for triage and patient management.

Keywords: emergency department; acute myocardial infarction; point of care high sensitivity cardiac troponin assay; early rule out; early rule in
Corresponding author: Vincenzo De Iuliis, MD, Department of Clinical Pathology, G. Mazzini Civil Hospital, Teramo, Italy, Phone: +39 0861429324, E-mail:

  1. Research ethics: The study was conducted in accordance with the Declaration of Helsinki.

  2. Informed consent: Not applicable.

  3. Author contributions: The authors have accepted responsibility for the entire content of this manuscript and approved its submission.

  4. Competing interests: The authors state no conflict of interest.

  5. Research funding: None declared.

  6. Data availability: The raw data can be obtained on request from the corresponding author.

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Supplementary Material

This article contains supplementary material (https://doi.org/10.1515/cclm-2024-0225).

Received: 2024-02-17
Accepted: 2024-04-16
Published Online: 2024-04-29
Published in Print: 2024-10-28

© 2024 Walter de Gruyter GmbH, Berlin/Boston

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https://doi.org/10.1515/cclm-2024-0225
Schlagwörter für diesen Artikel
emergency department; acute myocardial infarction; point of care high sensitivity cardiac troponin assay; early rule out; early rule in

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. Circulating tumor DNA measurement: a new pillar of medical oncology?
  4. Reviews
  5. Circulating tumor DNA: current implementation issues and future challenges for clinical utility
  6. Circulating tumor DNA methylation: a promising clinical tool for cancer diagnosis and management
  7. Opinion Papers
  8. The final part of the CRESS trilogy – how to evaluate the quality of stability studies
  9. The impact of physiological variations on personalized reference intervals and decision limits: an in-depth analysis
  10. Computational pathology: an evolving concept
  11. Perspectives
  12. Dynamic mirroring: unveiling the role of digital twins, artificial intelligence and synthetic data for personalized medicine in laboratory medicine
  13. General Clinical Chemistry and Laboratory Medicine
  14. Macroprolactin in mothers and their babies: what is its origin?
  15. The influence of undetected hemolysis on POCT potassium results in the emergency department
  16. Quality control in the Netherlands; todays practices and starting points for guidance and future research
  17. QC Constellation: a cutting-edge solution for risk and patient-based quality control in clinical laboratories
  18. OILVEQ: an Italian external quality control scheme for cannabinoids analysis in galenic preparations of cannabis oil
  19. Using Bland-Altman plot-based harmonization algorithm to optimize the harmonization for immunoassays
  20. Comparison of a two-step Tempus600 hub solution single-tube vs. container-based, one-step pneumatic transport system
  21. Evaluating the HYDRASHIFT 2/4 Daratumumab assay: a powerful approach to assess treatment response in multiple myeloma
  22. Insight into the status of plasma renin and aldosterone measurement: findings from 526 clinical laboratories in China
  23. Reference Values and Biological Variations
  24. Reference values for plasma and urine trace elements in a Swiss population-based cohort
  25. Stimulating thyrotropin receptor antibodies in early pregnancy
  26. Within- and between-subject biological variation estimates for the enumeration of lymphocyte deep immunophenotyping and monocyte subsets
  27. Diurnal and day-to-day biological variation of salivary cortisol and cortisone
  28. Web-accessible critical limits and critical values for urgent clinician notification
  29. Cancer Diagnostics
  30. Thyroglobulin measurement is the most powerful outcome predictor in differentiated thyroid cancer: a decision tree analysis in a European multicenter series
  31. Cardiovascular Diseases
  32. Interaction of heparin with human cardiac troponin complex and its influence on the immunodetection of troponins in human blood samples
  33. Diagnostic performance of a point of care high-sensitivity cardiac troponin I assay and single measurement evaluation to rule out and rule in acute coronary syndrome
  34. Corrigendum
  35. Reference intervals of 24 trace elements in blood, plasma and erythrocytes for the Slovenian adult population
  36. Letters to the Editor
  37. Disturbances of calcium, magnesium, and phosphate homeostasis: incidence, probable causes, and outcome
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  43. 56th National Congress of the Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC – Laboratory Medicine)
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