Comparison of point-of-care testing and laboratory testing of myocardial damage markers in the diagnosis and prognosis of acute coronary syndrome

Abstract

Objective To compare the point-of-care testing (POCT) and laboratory testing of myocardial damage markers in the diagnosis and prognosis of acute coronary syndrome (ACS).Methods A total of 3467 patients with ACS who were treated in the Emergency Department Beijing Chaoyang Hospital Affiliated to Capital Medical University between January 1,2006 and June 30,2010 were retrospectively reviewed.The patient demographics (age,sex,past medical history and smoking history) and laboratory testing results (myocardial damage markers,D-dimer,NTproBNP,and ejection fraction [EF]) were analyzed.The patients who received POCT or laboratory testing of myocardial damage markers were compared with regard to emergency department stay (i.e.,the time from the emergency visit to interventional or conservative treatment),cardiovascular events during hospitalization (congestive heart failure,ventricular fibrillation,and cerebrovascular disease),and 28-day mortality rate.Results The emergency department stay,incidence of a cardiovascular event,and 28-day mortality in the POCT group were all lower than that in the laboratory testing group (P =0.000).A prolonged emergency department stay result in an increased incidence of 28-day mortality.The higher level of D-dimer and decreased EF prompted an increased incidence of 28-day mortality.Conclusions Compared with conventional laboratory testing,POCT can significantly shorten the length of an emergency department stay for an ACS patient,decrease the incidence of a cardiovascular event,and improve the prognosis. Key words: Acute coronary syndrome ; Point-of-care testing (POCT) ; Myocardial damage markers; Prognosis