Troponin testing at the point of care

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Troponin tests at the emergency department

When a patient arrives at the emergency department (ED) with chest pain and no or unclear changes on the electrocardiogram (ECG), the ED physician typically orders serial troponin tests [1].

This is to establish if the symptoms are caused by an acute myocardial infarction (AMI) - a heart attack - and to determine the next steps which could either be ruling in a patient for an intervention—or ruling the patient out [1].

*No interference from Biotin up to 2.6 mg/L (2,600 ng/mL).

Immunoassay products and solutions

CRP (C-reactive protein)

D-dimer

NT-proBNP

PCT (Procalcitonin)

Troponin I

βhCG (Human chorionic gonadotropin)

Troponins are specific markers of cardiac muscle injury

Troponins are proteins of the muscular thin filaments and part of a complex in striated muscle [2].

Cardiac troponins are components of the contractile apparatus of myocardial cells and are expressed almost exclusively in the heart and are the preferred biomarker for the evaluation of myocardial injury. Myocardial injury is defined as being present when blood levels of cTn are increased above the 99th percentile upper reference limit (URL). When the injury is associated with a rising and/or falling pattern of cTn values it indicates myocardial ischaemia and is designated as an acute myocardial infarction [3].

Troponins - an aid in diagnosing myocardial infarction

The diagnosis of myocardial infarction (MI) is based on the detection of a rise and/or fall of cTn values with at least one value above the 99th percentile URL in combination with ECG or imaging changes, ischemic symptoms or other clinical findings [3].

For patients with myocardial infarction, the timing of biomarker release into the blood stream is dependent on the patient´s blood flow. Accordingly, measured biomarker concentrations are dependent on how soon after the onset of symptoms, samples are obtained [3].

Troponin tests on the AQT90 FLEX analyzer

The AQT90 FLEX immunoassay analyzer is a benchtop analyzer that brings rapid biomarker assessment capabilities right to the patient’s bedside.

The AQT90 FLEX TnI test is indicated for use as an aid in diagnosing myocardial infarction and in the stratification of patients with acute coronary syndromes.

The AQT90 FLEX analyzer delivers quantitative results on the TnI in less than 19 minutes, accelerating myocardial infarction diagnosis in the ED to support rapid clinical decision making.

Its closed tube system makes troponin testing easy: the operator simply inserts the sample tube into the tube holder in the sample port and the analyzer performs all assay steps automatically. There is no need for sample preparation.

All necessary reagents are included in the test cartridges, which remain stable onboard the analyzer for 17 days ensuring maximum availability and uptime.

Learn more about the AQT90 FLEX analyzer

Product image of the AQT90 FLEX analyzer from Radiometer

Key benefits of Troponin I on the AQT90 FLEX analyzer

No blood exposure: closed system
No sample or assay preparation
No presence of hook effect, carry-over or known interferences at clinically relevant concentrations
Interference from heterophilic antibodies are minimized by adding a blocker substance
Specimen types: venous whole blood and plasma
Sample tubes: Fits most 13 × 75 mm standard tubes

Troponin I assay specifics

Turnaround time:

< 19 min.

CV % (plasma): Within-lab CV% at conc. 0.021 μg/L: 12.9%

99th percentile*: 0.023 μg/L

* This value should only be used as an example. Each laboratory should establish its own decision threshold level.

References

1. Collet, J, Thiele, K, Barbato, E, et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation, European Heart Journal August 2020
2. Welsh P, Preiss D, Sattar N. Utility of High-Sensitivity Troponin T and I: Are They the Same? Expert analysis in American College of Cardiology (acc.org) Assessed Nov 2021.
3. Thygesen K, Alpert JS, Jaffe AS, et al., Fourth universal definition of myocardial infarction J Am Coll Cardiol Oct 2018; 72(18):2231-2264

MAPSSS-000754 R2

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