What question did this study set out to answer?

To evaluate the analytical concordance and diagnostic accuracy of point-of-care and contemporary cardiac troponin assays compared to high-sensitivity assays across various cutoff thresholds.

December 1, 2018The Journal of Applied Laboratory MedicineOpen Access

Pick a Number, Any Number…Choosing Your Troponin Cutoff Wisely

Q: What is the clinical evidence from this study?

Study design: Editorial. Population: Coronary care unit admission (n=102). Intervention: Point-of-care and contemporary cTnI assays vs. High-sensitivity cTnI (hs-cTnI) assay. Primary outcome: Analytical concordance >90% between reference hs-cTnI method and test method.

View Full Paper

Ask AI

Bookmark

Key result

Point-of-care and contemporary troponin assays demonstrated poor analytical concordance compared with a high-sensitivity assay at the 99th percentile, with false-negative rates up to 33%.

Population

102 patients admitted to a single coronary care unit

Comparison

Point-of-care cTnI assays and central laboratory… vs High-sensitivity cTnI (hs-cTnI) assay

Design

Editorial

Authors

ASAmy K. SaengerPreventive Cardiology

Discussion

Member takes

Implication

Analytical concordance between POC/contemporary troponin assays and hs-cTn assays is poor at the 99th percentile, emphasizing the need for assay-specific cutoffs and caution against interchangeable interpretation.

Key Points

To evaluate the analytical concordance and diagnostic accuracy of point-of-care and contemporary cardiac troponin assays compared to high-sensitivity assays across various cutoff thresholds.
Evaluated plasma and whole blood samples from 102 patients admitted to a single coronary care unit.
Measured analytical concordance against a reference high-sensitivity cardiac troponin I (hs-cTnI) assay, targeting >90% concordance across multiple point-of-care and contemporary laboratory platforms.
Compared false-negative and false-positive rates at manufacturer-recommended 99th percentile upper reference limits versus alternative assay cutoffs.
Analytical concordance at the recommended 99th percentile was poor, with false-negative rates of 19% for Alere Triage, 33% for Radiometer AQT90 and Abbott i-STAT, 7% for Beckman Coulter heparin, and 20% for Beckman Coulter EDTA.
The contemporary Beckman Coulter cTnI assay exhibited high false-positive rates reaching up to 16% in lithium heparin and 12% in EDTA plasma.
Lowering the Abbott i-STAT cutoff from 0.08 μg/L to 0.03 μg/L improved the true-positive rate from 67% to 98% and reduced the false-negative rate from 33% to 3%.

Structured PICO

Population

102 patients admitted to a single coronary care unit.

Exposure

Point-of-care (POC) cTnI assays and central laboratory contemporary cTnI assay

Comparator

High-sensitivity cTnI (hs-cTnI) assay

Outcome

Analytical concordance at various cTn cutoffssurrogate

Cite This Study

Amy K. Saenger (2018) conducted an editorial in Coronary care unit admission (n=102). Point-of-care and contemporary cTnI assays vs. High-sensitivity cTnI (hs-cTnI) assay was evaluated on Analytical concordance >90% between reference hs-cTnI method and test method. Point-of-care and contemporary troponin assays demonstrated poor analytical concordance compared with a high-sensitivity assay at the 99th percentile, with false-negative rates up to 33%.

synapsesocial.com/papers/6a7c50f552b1b268054008bb https://doi.org/10.1373/jalm.2018.027714

View Full Paper

Ask AI

Bookmark

Pick a Number, Any Number…Choosing Your Troponin Cutoff Wisely

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Pick a Number, Any Number…Choosing Your Troponin Cutoff Wisely

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider