| Summary: | The American Cardiovascular Society recommends measuring cardiac troponin (cTn) I or T levels in patients presenting with symptoms of acute coronary syndrome (ACS). cTn levels increase with damage to the heart from an insufficient blood supply, and measuring these levels is a sensitive test for the detection of heart muscle damage. However, cTn levels may also be elevated in other conditions, and therefore clinical assessment and electrocardiogram (ECG) findings are also required to diagnose myocardial infarction (MI). ACS includes ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), and unstable angina. Because NSTEMI does not exhibit changes typical of an MI on ECG, measurement of cTn is important for diagnosis. Troponin is typically measured by central laboratory testing; however, central laboratories are not always available, particularly in rural or remote settings. Point-of-care (POC) cTn testing therefore has the potential to improve patient care in these settings, reducing unnecessary and often expensive transfers to hospitals, and allowing patients to receive care in their community. To assist decision-makers considering the implementation of POC troponin testing, CADTH conducted a health technology assessment (HTA) on the clinical utility, diagnostic accuracy, and cost-effectiveness of POC troponin testing in different settings. Settings with access to a central laboratory (such as an emergency department [ED]), and settings with no immediate access to a central laboratory (such as rural hospitals or health care centres, remote settings, or remote nursing stations) were considered
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