Point-of-care high-sensitivity assay on PATHFAST as the backup in the emergency room

Joško Osredkar; Katja Krivic; Teja Fabjan; Kristina Kumer; Jure Tršan; Laura Poljančič; Petra Finderle; Hugon Možina

doi:10.1177/23992026211055095

Point-of-care high-sensitivity assay on PATHFAST as the backup in the emergency room

Med Access Point Care. 2021 Oct 26:5:23992026211055095. doi: 10.1177/23992026211055095. eCollection 2021 Jan-Dec.

Authors

Joško Osredkar^{1

2}, Katja Krivic², Teja Fabjan¹, Kristina Kumer¹, Jure Tršan³, Laura Poljančič⁴, Petra Finderle¹, Hugon Možina^{3

5}

Affiliations

¹ Institute of Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, Ljubljana, Slovenia.
² Faculty of Pharmacy, University of Ljubljana, Ljubljana, Slovenia.
³ Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
⁴ Department of Anaesthesiology and Surgical Intensive Care, Division of Surgery, University Medical Centre Ljubljana, Ljubljana, Slovenia.
⁵ Medical Emergency Unit, Division of Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Abstract

Aim: Although the levels of cardiac troponin I (cTnI) have proved to be a useful diagnostic biomarker of acute myocardial infarction, there are a wide variety of point-of-care (POC) analysers, which provide measurements of cTnI. The aim of this study was to compare the results obtained by the ADVIA Centaur ultra-assay cTnI assay (us-cTnI), ADVIA Centaur high-sensitive cTnI assay (hs-cTnI) and a POC high-sensitivity assay using PATHFAST. We also aimed to explore total turnaround time (TAT) for laboratory results using the POC PATHFAST analyser.

Methods: Samples from 161 patients were taken. Of these samples, 129 were tested with all three assays (us-cTnI, hs-cTnI and PATHFAST), and 32 samples were tested on PATHFAST for the comparison of whole blood, serum and plasma.

Results: Comparison of the POC testing methods in this study demonstrated that there are strong linear relationships between all three cTnI assays (us-cTnI, hs-cTnI and POC on PATHFAST). Furthermore, we also show there are strong linear relationships between the two high-sensitive cTnI assays (hs-cTnI and PATHFAST) for blood serum samples, as determined by Passing-Bablok regression analyses. In our comparison of our new data with our older study, the TAT went down.

Conclusion: The timeliness of laboratory results is, in addition to accuracy and precision, one of the key indicators of laboratory performance, and at the same time has a significant impact on the course of the patient's condition. It is therefore important that the laboratory strives to meet the expectations of clinicians regarding the time from the order to the result of the analysis.

Keywords: Acute coronary syndrome; point-of-care testing; troponin I; turnaround time.