[Real-life evaluation of hypersensitive I-troponin on a point-of care analyser in an emergency unit].

IF 0.4 4区 医学 Q4 MEDICAL LABORATORY TECHNOLOGY
Léo Mottin, Iliasse Idrissi Kassimy, Hélène Girot, Romain Leguillon, Luc Marie Joly, Valery Brunel
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引用次数: 0

Abstract

European Society of Cardiology (ESC) guidelines allow to perform rapid rule-in and rule-out algorithm with rapid troponin kinetics for the management of suspected Non ST-elevation acute coronary syndrome. These recommendations allow the use of point-of-care testing (POCT) systems provided that they have sufficient analytical performance. The aim of our study was to evaluate in real life the feasibility and performance of using a high sensitivity cardiac troponin I POCT system assay (hs-cTnI, Atellica® VTLi, Siemens) compared to high sensitivity cardiac troponin T values (hs-cTnT, e602®, Roche) obtained for patients admitted to emergency department. Analytical verification showed a coefficient of variation below 10% for hs-cTnI. Comparison of both troponins was moderate (r = 0.7). The study included 117 patients with a median age of 65 years, 30% had renal failure and 36% presented with chest pain. In this study, the hs-cTnT value was, more often, higher than the 99th percentile than the hs-cTnl value, even for an age-adjusted 99th percentile hs-cTnT value. The concordance of the results was moderate (Cohen's Kappa: 0.54), age remaining the most important explanatory value of discordance. Only hs-cTnT had a predictive value for hospitalization. We did not observe any interpretation discrepancies for patients who had troponin kinetics. This study confirms the feasibility of using a POCT analyzer in the emergency department, provided that it performs high sensitivity troponin. However, some data are missing to be able to use it in the framework of rapid algorithm. Finally, the implementation of POCT requires collaboration between biologists and emergency physicians in terms of organization and interpretation of values, for the overall benefit of the patient.

[在急诊病房的即时护理分析仪上对超敏感肌钙蛋白的真实评估]。
欧洲心脏病学会(ESC)指南允许对疑似非st段抬高急性冠状动脉综合征患者采用快速肌钙蛋白动力学快速规则入和排除算法。这些建议允许使用护理点检测(POCT)系统,只要它们具有足够的分析性能。本研究的目的是在现实生活中评估使用高灵敏度心肌肌钙蛋白I POCT系统测定(hs-cTnI, Atellica®VTLi, Siemens)与高灵敏度心肌肌钙蛋白T值(hs-cTnT, e602®,Roche)在急诊科住院患者中获得的可行性和性能。分析验证表明hs-cTnI的变异系数小于10%。两种肌钙蛋白比较为中等水平(r = 0.7)。该研究包括117名患者,中位年龄为65岁,30%患有肾衰竭,36%表现为胸痛。在本研究中,hs-cTnT值通常高于hs-cTnT值的第99百分位数,即使是年龄调整后的第99百分位数hs-cTnT值也是如此。结果的一致性为中等(Cohen’s Kappa: 0.54),年龄仍然是不一致性的最重要解释价值。只有hs-cTnT对住院有预测价值。我们没有观察到有肌钙蛋白动力学的患者有任何解释差异。本研究证实了在急诊科使用POCT分析仪的可行性,前提是它具有高灵敏度的肌钙蛋白。然而,在快速算法的框架下,还缺少一些数据。最后,为了患者的整体利益,POCT的实施需要生物学家和急诊医生在组织和解释价值观方面进行合作。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Annales de biologie clinique
Annales de biologie clinique 医学-医学:研究与实验
CiteScore
0.80
自引率
20.00%
发文量
53
审稿时长
6-12 weeks
期刊介绍: Multidisciplinary information with direct relevance to everyday practice Annales de Biologie Clinique, the official journal of the French Society of Clinical Biology (SFBC), supports biologists in areas including continuing education, laboratory accreditation and technique validation. With original articles, abstracts and accounts of everyday practice, the journal provides details of advances in knowledge, techniques and equipment, as well as a forum for discussion open to the entire community.
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