High-sensitivity troponin: bringing testing to the point of patient care

High-sensitivity assays and point-of-care testing are having a significant effect on how quickly acute coronary syndrome can be examined. Here, Holger Gundelach discusses how this is improving patient outcomes.

Rapid diagnosis is obviously critical when a patient presents with suspected acute coronary syndrome (ACS), not only to guide the patient to the appropriate treatment as quickly as possible, but also to reduce waiting times and unnecessary hospital admissions. Laboratory-based troponin assays have long been used to rule out ACS, including myocardial infarction (MI), but this pathway can take several hours to reach a conclusion in worst-case scenarios.

                Every five minutes a patient is admitted to a UK hospital with a heart attack, resulting in a staggering 100,000 admissions every year.1 The condition is caused when the supply of blood to the coronary artery becomes obstructed, reducing or preventing the flow of blood and oxygen to the heart.2 Cells of the myocardium begin to die with oxygen deprivation, so there is no time to lose when a patient presents with symptoms such as chest pain or shortness of breath.

                A rapid diagnosis can guide patients to appropriate revascularisation treatment quickly, helping to preserve precious heart muscle and improve clinical outcomes. This is not only beneficial for the patient, but also helps to alleviate the burden on hospitals, freeing beds and reducing accident and emergency (A&E) waiting times by avoiding unnecessary admissions. In addition, the economic benefit of safely ruling out this condition sooner cannot be underestimated, with it costing on average £500 per day to occupy a hospital bed in the UK.3 Rapid testing also helps emergency departments (ED) to avoid paying fines for exceeding the four-hour waiting target set out by the NHS, resulting in further savings.4

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