Single High-Sensitivity Cardiac Troponin Measurement to Rule-out/Rule-in Myocardial Infarction in the Emergency Department
Abstract
Background Point-of-care (POC) testing and triage liaison physicians could help alleviate the impact of emergency department (ED) overcrowding. The aim of our study was to evaluate the diagnostic performance of the TriageTrue POC assay for the rapid rule-out of myocardial infarction based on a single measurement of high-sensitivity cardiac troponin I (hs-CTnI). The diagnostic performance was compared to measurements obtained with the Vitros 3600 assay, taking into account the cutoffs recommended by the European Society of Cardiology. Methods The study compared results of troponin obtained simultaneously on the TriageMeterPro device from whole blood and plasma samples (n = 139) and the hs-cTnI assay on the Vitros 3600 instrument from EDTA plasma samples (n = 225). The diagnostic performance of the 3 methods was compared, including negative predictive value and sensitivity as well as positive predictive value and specificity. Concordance between the methods with disease state samples was then assessed using the Cohen kappa test. Results An excellent correlation between plasma and whole blood samples was achieved with the TriageTrue with a coefficient of correlation >0.99 and a bias of +8.2 (±45, with 95% CI 0.4 to 16.0) ng/L. A significant overestimation (around 47%) of the values obtained with the TriageTrue compared with those of the Vitros was also observed. Our results confirmed the acceptable and comparable diagnostic accuracy to the established hs-cTnI-Vitros assay, with a negative predictive value of 100% to rule-out myocardial infarction. Conclusion Our results demonstrated that the TriageTrue hs-cTnI whole blood test could serve as an alternative method for ruling out or confirming non-ST-elevation myocardial infarction in the prehospital setting using a single POC troponin measurement.
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BibTeX
@article{dupuy2026single,
title = {{Single High-Sensitivity Cardiac Troponin Measurement to Rule-out/Rule-in Myocardial Infarction in the Emergency Department}},
author = {Anne Marie Dupuy and Yanis Gueche and Anne Sophie Bargnoux and Marion Morena and Bruno Lehodey and François Roubille and Jean Paul Cristol},
journal = {The Journal of Applied Laboratory Medicine},
year = {2026},
month = aug,
doi = {10.1093/jalm/jfag130},
url = {https://hal.science/hal-05733574v1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Single High-Sensitivity Cardiac Troponin Measurement to Rule-out/Rule-in Myocardial Infarction in the Emergency Department
AU - Anne Marie Dupuy
AU - Yanis Gueche
AU - Anne Sophie Bargnoux
AU - Marion Morena
AU - Bruno Lehodey
AU - François Roubille
AU - Jean Paul Cristol
PY - 2026
DA - 2026/08/31
JO - The Journal of Applied Laboratory Medicine
DO - 10.1093/jalm/jfag130
UR - https://hal.science/hal-05733574v1
AB - Background Point-of-care (POC) testing and triage liaison physicians could help alleviate the impact of emergency department (ED) overcrowding. The aim of our study was to evaluate the diagnostic performance of the TriageTrue POC assay for the rapid rule-out of myocardial infarction based on a single measurement of high-sensitivity cardiac troponin I (hs-CTnI). The diagnostic performance was compared to measurements obtained with the Vitros 3600 assay, taking into account the cutoffs recommended by the European Society of Cardiology. Methods The study compared results of troponin obtained simultaneously on the TriageMeterPro device from whole blood and plasma samples (n = 139) and the hs-cTnI assay on the Vitros 3600 instrument from EDTA plasma samples (n = 225). The diagnostic performance of the 3 methods was compared, including negative predictive value and sensitivity as well as positive predictive value and specificity. Concordance between the methods with disease state samples was then assessed using the Cohen kappa test. Results An excellent correlation between plasma and whole blood samples was achieved with the TriageTrue with a coefficient of correlation >0.99 and a bias of +8.2 (±45, with 95% CI 0.4 to 16.0) ng/L. A significant overestimation (around 47%) of the values obtained with the TriageTrue compared with those of the Vitros was also observed. Our results confirmed the acceptable and comparable diagnostic accuracy to the established hs-cTnI-Vitros assay, with a negative predictive value of 100% to rule-out myocardial infarction. Conclusion Our results demonstrated that the TriageTrue hs-cTnI whole blood test could serve as an alternative method for ruling out or confirming non-ST-elevation myocardial infarction in the prehospital setting using a single POC troponin measurement.
SN - 2576-9456
ER -