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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

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Integration between point-of-care cardiac markers in an emergency/cardiology department and the central laboratory: methodological and preliminary clinical evaluation

Francesca Di Serio1 / Gianfranco Amodio2 / Lucia Varraso3 / Maurizio Campaniello4 / Paola Coluccia5 / Paolo Trerotoli6 / Gianfranco Antonelli7 / Nicola Pansini8

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Corresponding author: Francesca Di Serio, Via Cardinale Mimmi 16, 70124 Bari, Italy Phone: +39-080-5592629/124, Fax: +39-080-5592124,

Citation Information: Clinical Chemical Laboratory Medicine. Volume 43, Issue 2, Pages 202–209, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: 10.1515/CCLM.2005.035, April 2005

Publication History

Received:
November 6, 2004
Accepted:
December 10, 2004

Abstract

To achieve rapid assessment of chest pain in emergency/cardiology departments, a short turnaround time for cardiac marker testing is necessary. Nevertheless, Total Quality Management principles must be incorporated into the management of point-of-care testing (POCT); in this setting we implemented the Stratus CS ® assay as POCT for cardiac markers in our emergency/cardiology department. The analytical performance of the troponin I method was evaluated; information connectivity between the Stratus CS ® data management system and the laboratory information system was implemented and practical training of testing personnel was carried out at the POCT site. A total of 41 non-ST-segment elevation patients admitted to the hospital were followed to evaluate the appropriateness of hospital admission, formulated on the basis of the cardiac troponin-I level measured at the POCT site by clinical staff. Our preliminary clinical data suggest that the high sensitivity of the Stratus CS ® troponin method could play an important role in the early identification of patients with acute myocardial infarction in a low to intermediate-risk population for acute coronary syndrome. Our POCT model suggests that the central laboratory could ensure that the POCT program remains in compliance with quality requirements. Nevertheless, our comparison studies suggest that the implementation of POCT requires a high level of integration between cardiologists and pathologists to guarantee appropriate interpretation of the monitoring results for suspected ACS patients.

Keywords: acute myocardial infarction (AMI); emergency department; point-of-care testing (POCT); troponin I

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