A New Single-test Rule-out for Acute Myocardial Infarction?

By DocWire News Editors - Last Updated: October 19, 2018

A single 15-minute troponin concentration measurement using a novel point-of-care assay (Tnl-Nx) produced similar results to a lab-based high-sensitivity cardiac troponin assay for the rule-out of acute myocardial infarction (MI), new study results indicate. 

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Researchers for the preliminary cohort study included 354 patients presenting to the emergency department with acute MI symptoms. The authors compared the TnI-Nx assay to the hs-cTnl assay using area under receiver operator characteristic curve (AUC) and sensitivity, negative predictive value, and the proportion of negative test results at thresholds with 100% sensitivity. The primary study outcome was type 1 acute MI during index presentation.  

According to the results, there was no difference between the result of the Tnl-Nx assay (AUC=0.975; 95% CI, 0.958 to 0.993) and the hs-cTnl (AUC=0.970; 95% CI, 0.949 to 0.990; P=0.46). A TnI-Nx assay result of < 11 ng/L identified 56.7% of patients as low risk, with a sensitivity of 100% and a negative predictive value of 100%. In comparison, an hs-cTnI assay result of less than 3 ng/L identified 43.5% as low risk, with a sensitivity of 100%. 

https://twitter.com/cleebennett/statuses/1052927314969939969

The researchers noted in their conclusion that use of this assay in the emergency department “may facilitate earlier decision making and could expedite the safe discharge of a large proportion of low-risk patients.”

Source: JAMA Cardiology

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