![]() 1 Causes of chest pain vary from non-significant musculoskeletal pain to life-threatening acute coronary syndrome (ACS) and pulmonary embolism, as examples. Chest pain accounts for 5–20% of all ED visits. IntroductionĬhest pain is one of the most common symptoms in patients visiting the emergency department (ED) worldwide. We recommend that in patients presenting to the ED with chest pain undergo a repeat POC TnI assay at 3 h post admission to rule out acute coronary syndrome.Chest pain in patients with a negative POC TnI assay at 3 h post admission to the ED is unlikely to be of NSTEMI.The diagnostic performance of POC TnI was lower than that of Lab HsTnT at 0 hour.Recent research shows that troponin assays done within 3 h of arrival at the ED can rule out myocardial infarction.Most of the hospitals fail to meet the recommended turnaround time of less than 60 min from the time of blood drawn to the reporting of the final results.Measurement of cardiac markers in the blood is key in the evaluation of patients presenting with chest pain to the ED. ![]() Section 1: What is already known on this subject Keywords: point-of-care, POC, TnI, HsTnT, ED, chest pain, NSTEMI Hence we conclude that chest pain in patients with a negative POC TnI at 3 hours post-admission is unlikely to be due to NSTEMI. The POC TnI assay had a higher PPV than HsTnT, whereas both assays showed a high NPV at 0 and 3 hours.Ĭonclusion: Although the diagnostic performance of POC TnI was lower than that of Lab HsTnT at 0 hour, at 3 hours post-admission, the diagnostic performance was almost equal to that of HsTnT. At 3 hours post-admission, the sensitivity increased to 95% versus 100%, and specificity was 100% versus 94.3% when compared to lab HsTnT. At 0 hour, the POC TnI assay had a lower sensitivity (72.5% versus 97.5%) and had almost equal specificity (99.24% versus 93.2%) when compared to lab HsTnT assay. Results: Out of 313 patients enrolled, ten were excluded. The sensitivity, specificity, PPV, NPV, and AUC were determined and compared. A blood sample was collected at 0 and 3 hours post-admission for POC TnI and laboratory HsTnT assay. Patients with renal failure, initial ECG showing ST-elevation MI, or arrhythmias, and hemodynamically unstable patients were excluded. Patients more than 18 years old who presented to the ED with chest pain were enrolled. Methods: A prospective study was done at the ED of Alkhor Hospital, Hamad Medical Corporation, between March 2016 and December 2016. Here, we aimed to compare the diagnostic performance of the point-of-care troponin I assay with laboratory HsTnT assay in patients presenting to the ED with chest pain. Evaluation of chest pain depends on clinical symptoms and signs, ECG, and cardiac enzymes. Diagnosing acute coronary syndrome is a challenging task for emergency physicians. Hamad Medical Corporation, Doha 3050, Qatarīackground: Chest pain is a common symptom in patients visiting the emergency department (ED). Osama H Mohammad, 1 Vamanjore A Naushad, 1 Nishan K Purayil, 1 Laith Sinan, 2 Naseem Ambra, 1 Prem Chandra, 3 Firjeeth C Paramba, 1 Jassim Mohammad, 4 Sajid Chalihadan, 1 Irfan Varikkodan, 1 Azeez Palol 1ġDepartment of General Internal Medicine, Hamad Medical Corporation, Doha, Qatar 2Glasgow Medical College, Glasgow, UK 3Medical Research Center, Hamad Medical Corporation, Doha, Qatar 4Accident & Emergency Department, Hamad Medical Corporation, Doha, QatarĬorrespondence: Vamanjore A Naushad Department of General Internal Medicine ![]()
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