BEDSIDE TROPONIN-T TESTING IS NOT USEFUL FOR EARLY OUT-OF-HOSPITAL DIAGNOSIS OF MYOCARDIAL-INFARCTION

Background: A new commercially available rapid qualitative bedside imm unoassay for cardiac troponin T has been developed. The aim of the stu dy was to investigate whether this new rapid bedside cardiac troponin T assay facilitates diagnosing myocardial infarction in a pre-hospital setting. Methods: We evaluated the sensitivity and specificity of the new rapid bedside troponin T assay for myocardial infarction. In 68 p atients with acute, central, crushing chest pain, who were strongly su spected of having myocardial infarction, the emergency doctor performe d preclinically a bedside cardiac troponin T test. The results were co mpared with the diagnosis after admission to hospital, using the crite ria of the World Health Organization. Results: The diagnosis of myocar dial infarction was confirmed in 16/68 (24%) patients after admission to hospital, but only in 4/16 (25%) patients with myocardial infarctio n was a positive result observed preclinically with this test. The res ult was false positive in 1/5 patients (20%). Conclusions: In contrast to an excellent specificity (0.98), sensitivity (0.25) of the rapid t roponin T assay was poor. Thus, we conclude that this test cannot impr ove the distinction between myocardial infarction and angina pectoris in a pre-hospital setting.