Skip Navigation



QJM Advance Access published online on April 8, 2005
QJM, doi:10.1093/qjmed/hci052
This Article
Right arrow FREE Full Text (PDF) Freely available
Right arrow All Versions of this Article:
98/5/337    most recent
hci052v1
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Rajappan, K.
Right arrow Articles by Baker, C.S.R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Rajappan, K.
Right arrow Articles by Baker, C.S.R.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org
Received August 18, 2004
Revised March 7, 2005

Original papers

Usage of troponin in the real world: a lesson for the introduction of biochemical assays

K. Rajappan 1*, E. Murphy 2, V. Amber 2, F. Meakin 2, B. Muller 2, K.F. Fox 1, and C.S.R. Baker 1

1 Department of Cardiology, Charing Cross Hospital, London, UK
2 Department of Clinical Chemistry, Charing Cross Hospital, London, UK

* To whom correspondence should be addressed.
K. Rajappan, E-mail: krajappan{at}hhnt.org


  Abstract

Background: Studies have demonstrated economic and clinical effectiveness using troponin as a risk stratification tool in chest pain patients. Those with a positive result are investigated invasively, whilst those with a negative result and ECG are promptly mobilized, facilitating discharge.

Aim: To determine whether our use of troponin I (cTnI) in routine clinical practice conforms to ideal standards.

Design: Audit study.

Methods: Data were collected from 93 laboratory request forms for cTnI measurement on 72 patients with matched available patient records.

Results: Eighty requests had no information regarding timing of blood sample in relation to the clinical event; 39% gave no clinical indication. Only 71% of results were available within 12 h. An admission diagnosis of acute coronary syndrome (ACS) was made in 25%. Fifteen had typical cardiac chest pain with a negative cTnI: 6 of these had an exercise treadmill test before discharge. Nine had a positive cTnI, but only two had coronary angiography. Of patients with negative cTnI and possible ACS, 84% were in hospital for >4 days.

Discussion: The introduction of troponin assays into widespread use requires careful assessment. cTnI requests and subsequent patient management remain below expected standards. Ideally, the laboratory should provide an accurate result within a reasonable time frame, while physicians need to request cTnI at a suitable time-point and use the result appropriately. Lessons from the introduction of cTnI measurement may be useful for the introduction of future new tests in other areas of cardiology and medicine.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 QJMHome page
G. Lippi, G.L. Salvagno, M. Montagnana, and G.C. Guidi
How many troponins should we measure to get a clinically significant result?
QJM, June 1, 2007; 100(6): 389 - 390.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.