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Point of Care Cardiac Analyzers Yield Rapid Cardiac Marker Results


Helen Londe, M.D.
Contributing Editor

Clinical guidelines from the disciplines of cardiology and laboratory and emergency medicine have all emphasized the importance of cardiac markers in diagnosing or ruling out acute myocardial infarction. The measurement of cardiac troponins is especially useful in the large fraction of patients presenting with acute coronary syndrome (ACS) who have negative 12-lead EKGs. About 30% of patients previously considered to have unstable angina are now given a diagnosis of myocardial infarction without ST-segment elevation based on their cardiac troponin levels. Troponin levels additionally aid in risk stratification.

The development of accelerated protocols for diagnosing ACS in patients with chest pain necessitates the reduction of turnaround time (TAT) for cardiac marker results. Recommendations for the optimum TAT vary from 30 to 60 minutes. With regard to TAT, quantitative point of care (POC) assays that directly assay whole blood provide an attractive alternative to central lab testing. Although the advantages of rapid TAT must be balanced with the need for stringent quality control (QC), many POC analyzers have internal QC systems, and manufacturers provide external controls appropriate to each assay.

Biosite Inc., Response Biomedical Corp., and Roche Diagnostic Systems have FDA approved point of care technology to measure cardiac markers. The indications for use are for rapid quantitative measurement of markers to aid in the diagnosis of myocardial injuries.

Biosite Inc. offers the Triage Cardiac Panel, a fluorescence immunoassay for quantitative determination of CK-MB, myoglobin and troponin I in whole blood and plasma specimens using EDTA as the anticoagulant. To perform the test, a blood sample is added to the sample port of the test device from the Triage Cardiac Panel Kit. The device contains all the reagents for the test. After red blood cells are separated from plasma via filter
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