Can point-of-care high sensitivity troponin improve efficiency: a multisite US study
Open accessAbstract
BACKGROUND: New point-of-care (POC) high sensitivity troponin (hs-cTn) assays could improve chest pain care efficiency. This study seeks to determine whether implementation of POC hs-cTn reduces key Emergency Department (ED) time metrics. METHODS: A prospective cohort study was conducted at three U.S. EDs (February-September 2025). Adults without STEMI and at least one hs-cTnI ordered were accrued. Blood samples were collected simultaneously for POC hs-cTnI measurement on an i-STAT 1 analyzer (Abbott Laboratories) and central laboratory hs-cTnI measurement (Beckman Coulter). Following POC hs-cTn measures, providers were surveyed regarding potential disposition and treatment decisions which were compared to actual disposition times. Turnaround time, time-to-disposition, and ED length of stay for POC versus central laboratory measures were compared using Wilcoxon signed-rank tests. RESULTS: During the study period, 602 patients were accrued, of which 48% (286/602) were female and median age was 60 years (IQR: 50-70). POC hs-cTnI had a median turnaround time of 16 min (IQR: 15-17) compared to 52 min (IQR: 45-61) for the central laboratory, a 36-min difference (p < 0.001). Median time to potential disposition decision using POC was 222 min (IQR: 144-320) versus 273 min (IQR: 219-382) for central laboratory measures, a difference of 51 min (p < 0.001). The median potential ED length of stay was 325 min (IQR: 224-513) for POC versus 387 min (IQR: 276-564) for the central laboratory, yielding a potential reduction of 62 min (p < 0.001). CONCLUSIONS: POC hs-cTnI measurement reduced turnaround time and produced substantive potential reductions in time-to-disposition decision and ED length of stay. TRIAL REGISTRATION: NCT06899776.
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Motoyama, G., & Ito, H. (2026) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2026.09.060
Mahler, S. A., Ashburn, N. P., Villenthi, A., Pearson, D., Pugh, H. D., Hutchison, B. T., Supples, M., & Snavely, A. C. (2026) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2026.09.059
Self-citationReader Comment: Can point-of-care high sensitivity troponin improve efficiency: a multisite US study
Liu, C., & Xiao, L. (2026) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2026.09.058
Yazıcı, S. (2026) · The American Journal of Emergency Medicine · doi:10.1016/j.ajem.2026.10.018
- Authors
- Mahler, S. A., Ashburn, N. P., Villenthi, A., Pearson, D. A., Pugh, H. D., Hutchison, B. T., Supples, M. W., & Snavely, A. C.
- Affiliations
- Wake Forest University Health Sciences (US)
- Carolinas Medical Center (US)
- Corresponding author
- Mahler, Simon A.
- Venue
- The American Journal of Emergency Medicine
- Publisher
- Elsevier BV
- Published
- 2026-12
- Volume
- 110
- Pages
- 167-172
- ISSN
- 0735-6757 (ISSN-L)
- OpenAlex
- W7203786992
- Cited by
- 4
- References
- 16
- Citations by year
- 2026: 4
- FWCI
- 20.28
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- The American Journal of Emergency Medicine (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- Abbott Laboratories Inc
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Keywords
- point-of-care testing, high-sensitivity troponin I, emergency department efficiency, turnaround time, time to disposition, emergency department length of stay, chest pain, central laboratory comparison, non-ST-elevation myocardial infarction
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