What is the indication for cardiac marker point-of-care (POC) assays?

Updated: Jul 30, 2021
  • Author: Kamal (Komo) Gursahani, MD, MBA; Chief Editor: Barry E Brenner, MD, PhD, FACEP  more...
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Answer

The AACC recommendations specify that cardiac markers be available in hospitals on an immediate basis 24 hours per day, 7 days per week, with a turnaround time of 1 hour or less. [23, 29] Point-of-care (POC) devices that provide rapid results should be considered in hospitals whose laboratories cannot meet these guidelines.

POC assays for CK-MB, myoglobin, and the cardiac troponins TnI and TnT are available. Only qualitative TnT assays are available as POC tests, but both quantitative and qualitative POC TnI assays are currently marketed.

In a multicenter trial, the time to positivity was significantly faster for the POC device than for the local laboratory (2.5 h vs 3.4 h). [30]

In another multicenter study, which evaluated the i-STAT POC TnI assay in comparison with the central laboratory in 2000 patients with suspected acute coronary syndrome (ACS), POC testing reduced the length of stay by approximately 25 minutes for patients who were discharged from the ED. [31, 32] POC high-sensitivity assays are available as well. The increasing sensitivity of POC assays coupled with the benefit of rapid turnaround time make them attractive clinical tools in the ED.


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