Diagnostic Performance of Point-of-Care High-Sensitivity Troponin in the Exclusion of Non-ST-Elevation Myocardial Infarction in the Emergency Department

Zalama-Sánchez, Daniel; del Pozo Vegas, Carlos; Sanz-García, Ancor; de Santos-Castro, Pedro Ángel; Presencio-Dominguez, Javier; González-Izquierdo, Pablo; Sánchez-Ramón, Susana; Pinilla-Arribas, Leyre Teresa; Baladrón-Segura, Manuel; Cheayeb-Morán, Jaldún; Fernandez-García, María; Velasco de Cos, Guillermo; López-Izquierdo, Raúl; Martín-Rodríguez, Francisco

doi:10.3390/jpm14070762

Open AccessArticle

Diagnostic Performance of Point-of-Care High-Sensitivity Troponin in the Exclusion of Non-ST-Elevation Myocardial Infarction in the Emergency Department

by

Daniel Zalama-Sánchez

¹

,

Carlos del Pozo Vegas

^2,3

,

Ancor Sanz-García

^4,5,6,*

,

Pedro Ángel de Santos-Castro

³,

Javier Presencio-Dominguez

⁷,

Pablo González-Izquierdo

³,

Susana Sánchez-Ramón

⁷,

Leyre Teresa Pinilla-Arribas

³,

Manuel Baladrón-Segura

⁸

,

Jaldún Cheayeb-Morán

³,

María Fernandez-García

⁸,

Guillermo Velasco de Cos

⁹

,

Raúl López-Izquierdo

^2,7,10

and

Francisco Martín-Rodríguez

^2,11

¹

Emergency Department, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain

²

Faculty of Medicine, University of Valladolid, 47002 Valladolid, Spain

³

Emergency Department, Hospital Clínico Universitario, 47003 Valladolid, Spain

⁴

Faculty of Health Sciences, University of Castilla la Mancha, 45600 Talavera de la Reina, Spain

⁵

Technological Innovation Applied to Health Research Group (ITAS Group), Faculty of Health Sciences, University of Castilla La Mancha, 45004 Toledo, Spain

⁶

Evaluación de Cuidados de Salud (ECUSAL), Instituto de Investigación Sanitaria de Castilla-La Mancha (IDISCAM), 45071 Toledo, Spain

⁷

Emergency Department, Hospital Universitario Rio Hortega, 47012 Valladolid, Spain

⁸

Clinical Analysis Department, Hospital Universitario Rio Hortega, 47012 Valladolid, Spain

⁹

Clinical Analysis Department, Hospital Clínico Universitario, 47003 Valladolid, Spain

¹⁰

CIBER of Respiratory Diseases (CIBERES), Institute of Health Carlos III, 28029 Madrid, Spain

¹¹

Advanced Life Support, Emergency Medical Services (SACYL), 47007 Valladolid, Spain

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^*

Author to whom correspondence should be addressed.

J. Pers. Med. 2024, 14(7), 762; https://doi.org/10.3390/jpm14070762

Submission received: 5 July 2024 / Revised: 12 July 2024 / Accepted: 14 July 2024 / Published: 17 July 2024

(This article belongs to the Special Issue Precision Emergency Medicine)

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Abstract

Background: This study evaluates the diagnostic performance of high-sensitivity troponin using point-of-care testing (POCT) devices compared with main laboratory measurements for ruling out non-ST-elevation myocardial infarction (NSTEMI) in emergency department (ED) patients presenting with non-traumatic chest pain. Methods: This multicenter, observational, prospective, non-interventional study was conducted in two Spanish hospitals from 1 June to 31 December 2023 and included adult patients presenting with non-traumatic chest pain admitted to the ED. High-sensitivity troponin levels were measured using both the Siemens Atellica^® VTLi POCT device and main laboratory testing, with data collected on analytical results and measurement times. Results: Of the 201 patients who met the inclusion criteria, a significant correlation was observed between the POCT and laboratory assays. The area under the curve (AUC) of the ROC curve was consistently greater than 0.9, indicating a high diagnostic accuracy for ruling out NSTEMI. In addition, measurement times were significantly reduced using POCT compared to the core laboratory. Conclusion: These results suggest that high-sensitivity troponin POCT devices offer comparable diagnostic performance to traditional laboratory methods for the diagnosis of NSTEMI in the emergency department, potentially speeding up clinical decisions and optimizing resource utilization.

Keywords: non-ST-elevation myocardial infarction; troponin; point-of-care testing; emergency department

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MDPI and ACS Style

Zalama-Sánchez, D.; del Pozo Vegas, C.; Sanz-García, A.; de Santos-Castro, P.Á.; Presencio-Dominguez, J.; González-Izquierdo, P.; Sánchez-Ramón, S.; Pinilla-Arribas, L.T.; Baladrón-Segura, M.; Cheayeb-Morán, J.; et al. Diagnostic Performance of Point-of-Care High-Sensitivity Troponin in the Exclusion of Non-ST-Elevation Myocardial Infarction in the Emergency Department. J. Pers. Med. 2024, 14, 762. https://doi.org/10.3390/jpm14070762

AMA Style

Zalama-Sánchez D, del Pozo Vegas C, Sanz-García A, de Santos-Castro PÁ, Presencio-Dominguez J, González-Izquierdo P, Sánchez-Ramón S, Pinilla-Arribas LT, Baladrón-Segura M, Cheayeb-Morán J, et al. Diagnostic Performance of Point-of-Care High-Sensitivity Troponin in the Exclusion of Non-ST-Elevation Myocardial Infarction in the Emergency Department. Journal of Personalized Medicine. 2024; 14(7):762. https://doi.org/10.3390/jpm14070762

Chicago/Turabian Style

Zalama-Sánchez, Daniel, Carlos del Pozo Vegas, Ancor Sanz-García, Pedro Ángel de Santos-Castro, Javier Presencio-Dominguez, Pablo González-Izquierdo, Susana Sánchez-Ramón, Leyre Teresa Pinilla-Arribas, Manuel Baladrón-Segura, Jaldún Cheayeb-Morán, and et al. 2024. "Diagnostic Performance of Point-of-Care High-Sensitivity Troponin in the Exclusion of Non-ST-Elevation Myocardial Infarction in the Emergency Department" Journal of Personalized Medicine 14, no. 7: 762. https://doi.org/10.3390/jpm14070762

APA Style

Zalama-Sánchez, D., del Pozo Vegas, C., Sanz-García, A., de Santos-Castro, P. Á., Presencio-Dominguez, J., González-Izquierdo, P., Sánchez-Ramón, S., Pinilla-Arribas, L. T., Baladrón-Segura, M., Cheayeb-Morán, J., Fernandez-García, M., Velasco de Cos, G., López-Izquierdo, R., & Martín-Rodríguez, F. (2024). Diagnostic Performance of Point-of-Care High-Sensitivity Troponin in the Exclusion of Non-ST-Elevation Myocardial Infarction in the Emergency Department. Journal of Personalized Medicine, 14(7), 762. https://doi.org/10.3390/jpm14070762

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Diagnostic Performance of Point-of-Care High-Sensitivity Troponin in the Exclusion of Non-ST-Elevation Myocardial Infarction in the Emergency Department

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