Analytical and clinical performance of an improved qualitative troponin T rapid test in laboratories and critical care units

Objective.-To evaluate the performance of a visual troponin T rapid test in the hands of nontraditionally trained personnel of 2 critical care units i n comparison to 3 laboratories. Methods.-Method comparisons of the troponin T rapid test versus cardiac tro ponin T enzyme-linked immunosorbent assay were performed with 804 samples f rom 510 patients with suspected acute coronary syndromes. Crossreactivity w ith skeletal troponin T was studied up to 5000 mu g/L. Results.-Laboratories and critical care units obtained comparable results i n the analytical cutoff of the test (0.11 and 0.10 mu g/L) and in the diagn ostic sensitivities in the detection of acute myocardial infarction (96% an d 93% after 8 hours) and of high-risk patients with unstable angina pectori s (100% and 100%). Different percentages of false-positive results (0.2% an d 3%) were found, which may reflect different objectives and strategies in these hospital units. The cross-reactivity with skeletal troponin T was les s than 0.01%. Conclusions-The troponin T rapid test gives reliable results not only when used by laboratory personnel experienced in the execution of analytical met hods, but also in the hands of nurses and physicians working in clinical un its outside the laboratory.