Chest pain is a typical sign of myocardial infarction (MI). Older adults constitute two-thirds of the MI cases. Cardiac troponin (cTn), including cTnI and cTnT, is a standard biomarker of MI. Older adults generally have higher cTn concentrations, thus causing decreased diagnostic performance of cTn assays. Recently, the first point-of-care (POC) high-sensitivity (hs) cTnI analyser providing laboratory-standard results was introduced into the market. This study aims to evaluate the diagnostic performance of the POC hs-cTnI assay by comparing it with that of a laboratory hs-cTnI assay in older adults with chest pain. This was an observational study of consecutive older adults (≥65 years) presenting with chest pain to an emergency department from Hong Kong between 1 August and 8 December 2023. For the laboratory hs-cTnI assay, 5 ml of blood sample was collected. A drop of blood sample was drawn from the specimen tube for the POC hs-cTnI assay. The gold standard was the final diagnosis made by the attending physician. A total of 121 subjects (man age: 77.0 years) were recruited. The sensitivity of the two methods of assays was 100%, whilst the specificity of the POC and laboratory hs-cTnI assays was 94.1% and 85.6%, respectively. The POC hs-cTnI assay showed a higher specificity and similar sensitivity compared to the laboratory hs-cTnI assay, so it could be implemented to facilitate timely discharges of patients to rule out a MI diagnosis. The portable analyser could be used in non-hospital settings, such as ambulances and clinics.

Authors:
Jonathan Ka-ming Ho, Hong Kong Metropolitan University, Hong Kong
Janet Yuen-ha Wong, Hong Kong Metropolitan University, Hong Kong
Gary Tse, Hong Kong Metropolitan University, Hong Kong
Simon Ching Lam, Tung Wah College, Hong Kong
Andy Chun-yin Chong, Tung Wah College, Hong Kong
Calvin Chi-wai Chau, Queen Elizabeth Hospital, Hong Kong
Chi-yip Wong, Queen Elizabeth Hospital, Hong Kong
Johnson Wai-keung Tse, Queen Elizabeth Hospital, Hong Kong

About the Presenter(s)
Dr Jonathan Ho is currently an Assistant Professor at the School of Nursing and Health Studies of Hong Kong Metropolitan University.

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