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Ordóñez-Llanos, J. et al.

Risk stratification of chest pain patients by point-of-care cardiac troponin T and myoglobin measured in the emergency department.

A prospective multicenter study including 1410 chest pain patients with suspected acute coronary syndromes was carried out to examine the predictive value of biological cardiac markers for adverse events measured by a point-of-care system. Admission cardiac troponin T (cTnT) and myoglobin were measured in parallel on a point-of-care system in the emergency department and -- together with CK-MB mass -- on lab analyzers. In a one-year follow-up, cardiac and non-cardiac death, acute myocardial infarction, unstable angina pectoris and need for revascularization were registered. Median time between onset of symptoms and admission was 285 min; 172 patients (12.2%) had no event during follow-up. If the cTnT, measured either by the point-of-care system or a conventional lab analyzer, was >0.05 microg/L, then the chance of a cardiac event during the follow-up period was doubled (18% vs. 9%). Serial cTnT measurement did not add any further value to the predictive power of the admission cTnT. Myoglobin and CK-MB mass identified increasing risk with increasing concentration quartiles; cardiac event rates were 2.8- to 4.4-fold higher between the quartiles with the lowest and those with the highest analyte concentration, respectively. There was no difference in non-cardiac death rates between any concentration quartiles. In conclusion, the prediction of clinical events by cardiac troponin T and myoglobin measured with a point-of-care analyzer in the emergency department was as good as that of the same cardiac markers and CK-MB mass measured on lab analyzers.[1]

References

Risk stratification of chest pain patients by point-of-care cardiac troponin T and myoglobin measured in the emergency department. Ordóñez-Llanos, J., Santaló-Bel, M., Mercé-Muntañola, J., Collinson, P.O., Gaze, D., Haass, M., Katus, H.A., Chwallek, F., Hirschl, M.M., Derhaschnig, U., Mueller-Bardorff, M., Kellett, J., Sylvén, C., Schulz, I., Zerback, R. Clin. Chim. Acta (2006) [Pubmed]

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