The Point of Care Evaluation of high-sensitivity cardiac Troponin (POC-ET) study, is a multi-centre, prospective observational cohort study that aims to determine the optimal threshold and pathway for the early rule-out of MI using a Siemens POC device with a hs-cTnI assay in patients with suspected ACS. By taking POC blood samples at baseline, 1, 2 and 6 hours post presentation, the time from presentation to rule-out or rule-in MI for the POC test will be compared with the standard care laboratory reference standard.
For patients presenting to the ED with chest pain, the average length of stay remains longer than is necessary as a consequence of delays related to sampling, reporting and actioning results from a central laboratory. Recent developments in POC technology have improved the precision of cardiac troponin testing, such that it is now equivalent to the central laboratory hs-cTn assays with turn-around times of less than 10 minutes. Use of these technologies could transform the efficiency of chest pain pathways, and permit testing to be extended to the pre-hospital setting.
Furthermore, the use of capillary sampling may enable more frequent serial testing and identify new approaches to rule-out myocardial infarction in patients presenting within 2 hours of symptom onset. However, before POC hs-cTn assays can be used in clinical practice their clinical performance to rule-out and rule-in myocardial infarction needs to be determined.