Can a point-of-care troponin I assay be as good as a central laboratory assay? A MIDAS investigation

W. Frank Peacock, Deborah Diercks, Robert Birkhahn, Adam J. Singer, Judd E. Hollander, Richard Nowak, Basmah Safdar, Chadwick D. Miller, Mary Peberdy, Francis Counselman, Abhinav Chandra, Joshua Kosowsky, James Neuenschwander, Jon Schrock, Elizabeth Lee-Lewandrowski, William Arnold, John Nagurney

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: We aimed to compare the diagnostic accuracy of the Alere Triage Cardio3 Tropinin I (TnI) assay (Alere, Inc., USA) and the PathFast cTnI-II (Mitsubishi Chemical Medience Corporation, Japan) against the central laboratory assay Singulex Erenna TnI assay (Singulex, USA). Methods: Using the Markers in the Diagnosis of Acute Coronary Syndromes (MIDAS) study population, we evaluated the ability of three different assays to identify patients with acute myocardial infarction (AMI). The MIDAS dataset, described elsewhere, is a prospective multicenter dataset of emergency department (ED) patients with suspected acute coronary syndrome (ACS) and a planned objective myocardial perfusion evaluation. Myocardial infarction (MI) was diagnosed by central adjudication. Results: The C-statistic with 95% confidence intervals (CI) for diagnosing MI by using a common population (n = 241) was 0.95 (0.91-0.99), 0.95 (0.91-0.99), and 0.93 (0.89-0.97) for the Triage, Singulex, and PathFast assays, respectively. Of samples with detectable troponin, the absolute values had high Pearson (RP) and Spearman (RS) correlations and were RP =0.94 and RS=0.94 for Triage vs Singulex, RP =0.93 and RS=0.85 for Triage vs PathFast, and RP =0.89 and RS=0.73 for PathFast vs Singulex. Conclusions: In a single comparative population of ED patients with suspected ACS, the Triage Cardio3 TnI, PathFast, and Singulex TnI assays provided similar diagnostic performance for MI.

Original languageEnglish (US)
Pages (from-to)405-412
Number of pages8
JournalAnnals of Laboratory Medicine
Volume36
Issue number5
DOIs
StatePublished - Sep 1 2016
Externally publishedYes

Fingerprint

Point-of-Care Systems
Troponin I
Triage
Acute Coronary Syndrome
Assays
Myocardial Infarction
Hospital Emergency Service
Population
Troponin
Japan
Perfusion
Confidence Intervals
Statistics

Keywords

  • Diagnostic accuracy
  • Emergency medicine
  • Point-of-care
  • Troponin

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

Peacock, W. F., Diercks, D., Birkhahn, R., Singer, A. J., Hollander, J. E., Nowak, R., ... Nagurney, J. (2016). Can a point-of-care troponin I assay be as good as a central laboratory assay? A MIDAS investigation. Annals of Laboratory Medicine, 36(5), 405-412. https://doi.org/10.3343/alm.2016.36.5.405

Can a point-of-care troponin I assay be as good as a central laboratory assay? A MIDAS investigation. / Peacock, W. Frank; Diercks, Deborah; Birkhahn, Robert; Singer, Adam J.; Hollander, Judd E.; Nowak, Richard; Safdar, Basmah; Miller, Chadwick D.; Peberdy, Mary; Counselman, Francis; Chandra, Abhinav; Kosowsky, Joshua; Neuenschwander, James; Schrock, Jon; Lee-Lewandrowski, Elizabeth; Arnold, William; Nagurney, John.

In: Annals of Laboratory Medicine, Vol. 36, No. 5, 01.09.2016, p. 405-412.

Research output: Contribution to journalArticle

Peacock, WF, Diercks, D, Birkhahn, R, Singer, AJ, Hollander, JE, Nowak, R, Safdar, B, Miller, CD, Peberdy, M, Counselman, F, Chandra, A, Kosowsky, J, Neuenschwander, J, Schrock, J, Lee-Lewandrowski, E, Arnold, W & Nagurney, J 2016, 'Can a point-of-care troponin I assay be as good as a central laboratory assay? A MIDAS investigation', Annals of Laboratory Medicine, vol. 36, no. 5, pp. 405-412. https://doi.org/10.3343/alm.2016.36.5.405
Peacock, W. Frank ; Diercks, Deborah ; Birkhahn, Robert ; Singer, Adam J. ; Hollander, Judd E. ; Nowak, Richard ; Safdar, Basmah ; Miller, Chadwick D. ; Peberdy, Mary ; Counselman, Francis ; Chandra, Abhinav ; Kosowsky, Joshua ; Neuenschwander, James ; Schrock, Jon ; Lee-Lewandrowski, Elizabeth ; Arnold, William ; Nagurney, John. / Can a point-of-care troponin I assay be as good as a central laboratory assay? A MIDAS investigation. In: Annals of Laboratory Medicine. 2016 ; Vol. 36, No. 5. pp. 405-412.
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AU - Peacock, W. Frank

AU - Diercks, Deborah

AU - Birkhahn, Robert

AU - Singer, Adam J.

AU - Hollander, Judd E.

AU - Nowak, Richard

AU - Safdar, Basmah

AU - Miller, Chadwick D.

AU - Peberdy, Mary

AU - Counselman, Francis

AU - Chandra, Abhinav

AU - Kosowsky, Joshua

AU - Neuenschwander, James

AU - Schrock, Jon

AU - Lee-Lewandrowski, Elizabeth

AU - Arnold, William

AU - Nagurney, John

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N2 - Background: We aimed to compare the diagnostic accuracy of the Alere Triage Cardio3 Tropinin I (TnI) assay (Alere, Inc., USA) and the PathFast cTnI-II (Mitsubishi Chemical Medience Corporation, Japan) against the central laboratory assay Singulex Erenna TnI assay (Singulex, USA). Methods: Using the Markers in the Diagnosis of Acute Coronary Syndromes (MIDAS) study population, we evaluated the ability of three different assays to identify patients with acute myocardial infarction (AMI). The MIDAS dataset, described elsewhere, is a prospective multicenter dataset of emergency department (ED) patients with suspected acute coronary syndrome (ACS) and a planned objective myocardial perfusion evaluation. Myocardial infarction (MI) was diagnosed by central adjudication. Results: The C-statistic with 95% confidence intervals (CI) for diagnosing MI by using a common population (n = 241) was 0.95 (0.91-0.99), 0.95 (0.91-0.99), and 0.93 (0.89-0.97) for the Triage, Singulex, and PathFast assays, respectively. Of samples with detectable troponin, the absolute values had high Pearson (RP) and Spearman (RS) correlations and were RP =0.94 and RS=0.94 for Triage vs Singulex, RP =0.93 and RS=0.85 for Triage vs PathFast, and RP =0.89 and RS=0.73 for PathFast vs Singulex. Conclusions: In a single comparative population of ED patients with suspected ACS, the Triage Cardio3 TnI, PathFast, and Singulex TnI assays provided similar diagnostic performance for MI.

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KW - Emergency medicine

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