Point of care troponin testing is an extremely topical concept in Emergency Medicine. In this talk I'll explore the evidence for this technology, looking at the various assays available and how they can help us. I'll also ask what the future might look like, thanks to new technology like the Manchester Acute Coronary Syndromes (MACS) decision aid. Presented at Acute & General Medicine, London Excel, 2016

1. Timely, Convenient and Sensitive
Is point of care troponin testing the
future?

6. • 3 hours

7. Patient arrives
in the ED: T0
Blood taken
30-45 min
ECG
10 min
Triage
15 min
3h test
3h 30 - 3h 45
Result 1
2h 30
Result 2:
5h 30 - 5h 45
4h
3 h t r o p o n i n :
Ti m e l i n e

9. Proportion discharged with LoD
strategy
• 17% (Body, Clin Chem)
• 37% (Body, Acad EM)
• 19% (Carlton, JAMA Cardiol)
• And NICE recommends only discharge those with
TIMI 0-2 – actual admissions avoided will be few