Author/Editor		Markota, Andrej; Bernhardt, Matej; Palfy, Miroslav
Title		Primerjava hitrega, obposteljnega in laboratorijsko določenega troponina I
Translated title		Comparison of point-of-care and laboratory troponin I assays
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 80, št. 12
Publication year		2011
Volume		str. 905-8
Language		eng
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 comp are 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 Itest, 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 we re 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 trop on in results), then 6 (5-4%) false negative results and 1 (0.9%) false positive result we re 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). Conclusion: 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 trop on in assay primarily in patients at high-risk for acute coronary syndrome without ST elevation.
Summary		Izhodišče: V zadnjih letih smo priča pojavu analizatorjev troponina, ki omogočajo hitro določitev troponina ob bolniku. Pojavila so se poročila o neskladnosti med laboratorijsko določeno vrednostjo troponina in rezultati hitrih obposteljnih testov. Z raziskavo smo primerjali rezultate laboratorijsko določenega in hitrega obposteljnega testa za troponin I (i-STAT cardiac troponin I test, Abbott Point of Care). Metode: Opravljena je bila retrospektivna raziskava pri bolnikih s sumom na akutni koronarni sindrom, pri katerih smo hkrati odvzeli kri za določanje laboratorijskega in hitrega obposteljnega troponina I. Bolniki so bili obravnavani na Internistični nujni pomoči Univerzitetnega kliničnega centra Maribor med 23. novembrom in 21. decembrom 2010. Rezultati: V analizo je bilo vključenih 112 bolnikov. Pri 105 (93,8%) bolnikih so se rezultati obeh preiskav skladali. Ob predpostavki, da je laboratorijsko določena vrednost troponina zlati standard (diagnoza je bila postavljena na osnovi laboratorijskega testa), je bilo 6 izvidov (5,4%) lažno negativnih in 1 (0,9%) lažno pozitiven (občutljivost 81,2%, specifičnost 98,7%). Kljub temu nismo ugotovili statistično pomembne razlike med vrednostjo hitrega, obposteljnega troponina in laboratorijsko določeno vrednostjo troponina I (p=0,125). Zaključek: Glede na rezultate naše raziskave in podobnih raziskav smo se odločili za uporabo hitrega obposteljnega testa za troponin I pri bolnikih z visokim tveganjem za akutni koronarni sindrom brez dviga ST veznice. S hitrim testom dobimo dodaten podatek, ki lahko vpliva na izbiro načina zdravljenja. Za izključitev akutnega koronarnega sindroma brez dviga ST veznice pri bolnikih z nizkim tveganjem je smiselno laboratorijsko določanje troponina.
Descriptors		TROPONIN I TROPONIN I BLOOD CHEMICAL ANALYSIS POINT-OF-CARE SYSTEMS CORONARY DISEASE EMERGENCY MEDICAL SERVICES RETROSPECTIVE STUDIES