Comparison of point-of-care and laboratory troponin I assays

Abstract

BACKGROUND In recent years a number of pointof- care troponin assays have emerged. There have been reports of discrepancies between the results of point-of-care and laboratory assays. We sought to compare the results of point-ofcare and laboratory troponin I assays in patients with suspected acute coronary syndromes. METHODS A retrospective study was performed comparing the results of point-of-care (i-STAT cardiac troponin I test, Abbott Point of Care) and laboratory troponin I analysis in patients with suspected acute coronary syndrome treated in the Internal Medicine Emergency Department, University Medical Centre Maribor, between 23 November and 21 December 2010, who had blood samples drawn simultaneously for pointof- care and laboratory troponin I analysis. RESULTS 112 patients were included in the analysis. There was an agreement between the results of point-of-care and laboratory troponin analysis in 105 (93.8 %) patients. If we consider the laboratory results as »gold standard« (diagnosis was based on laboratory troponin results), then 6 (5.4 %) false negative results and 1 (0.9 %) false positive result were found (sensitivity 81.2 %, specificity 98.7 %). However, there was no statistically significant difference between point-of-care and laboratory troponin I analysis (p = 0.125). CONCLUSIONS We detected lower sensitivity of point-of-care assay, but there was no statistically significant difference between point-of-care and laboratory troponin I analysis. We adopted a strategy of using point-of-care troponin assay primarily in patients at high-risk for acute coronary syndrome without ST elevation.