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pISSN 2384-2458 eISSN 2288-7261
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Original Article

J Lab Med Qual Assur 2017; 39(2): 83-89

Published online June 30, 2017

https://doi.org/10.15263/jlmqa.2017.39.2.83

Copyright © Korean Association of External Quality Assessment Service.

Clinical Usefulness of Combined Cardiac Marker Testing with a Point-of-Care Device at the Emergency Department

Misuk Ji1, Hee-Won Moon2, Seungman Park3, Mina Hur2, Yeo-Min Yun2

1Department of Laboratory Medicine, Veterans Health Service Medical Center, Seoul, Korea,
2Department of Laboratory Medicine, Konkuk University School of Medicine, Seoul, Korea,
3Green Cross Laboratories, Yongin, Korea

Correspondence to:Yeo-Min Yun Department of Laboratory Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, 120-1 Neungdong-ro, Gwangjin-gu, Seoul 05030, Korea Tel: +82-2-2030-5582 Fax: +82-2-2030-5587 E-mail: ymyun@kuh.ac.kr
윤여민 우)05030 서울시 광진구 능동로 120-1, 건국대학교 의학전문대학원 진단검사의학과 Tel: 02)2030-5582, Fax: 02)2030-5587, E-mail: ymyun@kuh.ac.kr

Received: December 1, 2016; Revised: February 27, 2017; Accepted: April 10, 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background:

B-type natriuretic peptide (BNP) levels are elevated in various conditions unrelated to heart failure, such as acute coronary syndrome, and cardiac troponin (cTn) levels may also be elevated in several non-ischemic conditions. This study aimed to evaluate the clinical usefulness of combined cardiac marker testing (BNP and cTnI) with point-of-care devices in patients who presented to the emergency department (ED).

Methods:

Two thousand six hundred and seventy-four consecutive patients who visited the ED from March to August 2013 were included in this study. Cardiac marker testing was performed using the Triage Cardio3 panel (Alere, USA). Electronic medical records were collected on August 2014.

Results:

We found that 22.2% patients had elevated BNP and/or cTnI (12.8% with only elevated BNP, 4.4% with only elevated cTnI, and 5.0% with both elevations). Patients with elevations in both marker levels showed significantly higher admission rate (78.5% vs. 62.7%, P=0.006) and longer length of hospital stay (11 vs. 6 days, P=0.001) than those with only elevated cTnI. Patients with elevations in both marker levels also showed higher admission rate (78.5% vs. 67.3%, P=0.016) and higher BNP levels (430 vs. 194 pg/mL, P<0.001) than those with only elevated BNP.

Conclusions:

Concurrent elevation of BNP and cTnI may be associated with inferior clinical outcome and combined testing of cTnI and BNP levels with high sensitivity would provide important information for assisting management decisions at the ED.

Keywords: Troponin I, B-type natriuretic peptide, Emergency department

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