Point-of-Care Troponin T Testing in the Management of Patients with Chest Pain in the Swedish Primary Care. (10th January 2013)

• Record Type: Journal Article
• Authors: Nilsson, Staffan; Andersson, Per O.; Borgquist, Lars; Grodzinsky, Ewa; Janzon, Magnus; Kvick, Magnus; Landberg, Eva; Nilsson, Håkan; Karlsson, Jan-Erik
• Other Names: Muris Jean W. M. Academic Editor.
• Is Part Of: International journal of family medicine. Volume 2013(2013)
• Publication Date: 2013-01-10
• Subjects: Family medicine -- Periodicals; Family Practice; Family medicine; Periodical; Periodicals; Electronic journals; Fulltext; Internet Resources; Periodicals; 610.5
• DOI: 10.1155/2013/532093
• Languages: English
• ISSNs: 2090-2042

Abstract

Abstract : Objective . To investigate the diagnostic accuracy and clinical benefit of point-of-care Troponin T testing (POCT-TnT) in the management of patients with chest pain. Design . Observational, prospective, cross-sectional study with followup. Setting . Three primary health care (PHC) centres using POCT-TnT and four PHC centres not using POCT-TnT in the southeast of Sweden. Patients . All patients ≥35 years old, contacting one of the primary health care centres for chest pain, dyspnoea on exertion, unexplained weakness, and/or fatigue with no other probable cause than cardiac, were included. Symptoms should have commenced or worsened during the last seven days. Main Outcome Measures . Emergency referrals, patients with acute myocardial infarctions (AMI), or unstable angina (UA) within 30 days of study enrolment. Results . 25% of the patients from PHC centres with POCT-TnT and 43% from PHC centres without POCT-TnT were emergently referred by the GP (P = 0.011 ). Seven patients (5.5%) from PHC centres with POCT-TnT and six (8.8%) from PHC centres without POCT-TnT were diagnosed as AMI or UA (P = 0.369 ). Two patients with AMI or UA from PHC centres with POCT-TnT were judged as missed cases in primary health care. Conclusion . The use of POCT-TnT may reduce emergency referrals but probably at the cost of an increased risk to miss patients with AMI or UA.