Point-of-care testing (POCT) for cardiac conditions has evolved significantly over the past few decades. Where initially only basic diagnostic tests could be conducted in emergency rooms or clinics, portable cardiac POCT devices now allow for rapid diagnosis and management of heart attacks and other cardiac events. This has been enabled by the miniaturization of medical technologies as well as the development of easy-to-use, reliable platforms that can analyze biomarkers from small sample volumes.
Traditional cardiac testing involved sending samples to centralized laboratories for analysis, with turnaround times of several hours. However, during a heart attack, every minute matters - the earlier treatment begins, the more heart muscle can be saved from damage. Cardiac POC Testing Devices have helped address this challenge by bringing testing closer to the patient. Clinicians can now obtain biomarker results within 15-30 minutes to facilitate rapid clinical decision making. This has improved outcomes for cardiac patients.
Commonly Used Cardiac Biomarkers
A few key cardiac biomarkers are commonly analyzed using POCT platforms:
- Troponin: A sensitive and specific marker for myocardial injury. Testing for elevated troponin levels is central to the diagnosis of heart attacks.
- CK-MB: Creatine kinase-MB, an earlier marker of myocardial damage that preceded troponin. Still used but troponin is now the gold standard.
- myoglobin: An early marker released from damaged heart muscle, but less specific than troponin. Used occasionally to aid in triage.
- BNP/NT-proBNP: B-type and N-terminal proBNP peptides reflective of heart failure and increased filling pressures in the heart. Guides management of acute dyspnea or differentiated dyspnea from heart failure.
Advanced Platforms for Rapid Cardiac Biomarker Testing
Major companies offer a variety of portable, user-friendly cardiac POCT analyzers that can reliably measure levels of critical biomarkers like troponin from small sample volumes:
- Abbott i-STAT: Widely used handheld device that provides troponin test results in as little as 6 minutes from whole blood, plasma or serum. Connectivity allows data transfer.
- Roche Diagnostics cobas h 232 POC: Compact benchtop analyzer conducting a troponin or BNP test in 18 minutes. Integrates seamlessly with hospital IT systems.
- Beckman Coulter DxI: Another versatile POCT platform capable of running a panel of routine and specialized tests rapidly from whole blood in the clinical setting.
- Quidel Triage: Meter-sized cardiac biomarker testing device popular in emergency departments and clinics. Troponin results available within 15 minutes to aid in rapid rule-out or rule-in of heart attack.
- Siemens Atellica Solution: A modular, randomized-access POCT system featuring a robust cardiac test menu deliverable within 20 minutes to support acute cardiac care.
Benefits of Cardiac POCT
The growing use of sophisticated yet easy-to-operate cardiac POCT devices in hospitals, medical offices, and emergency departments has led to several benefits:
Faster Treatment: By obtaining biomarker results at the point of initial patient contact, clinicians can establish a quick diagnosis of acute coronary syndrome and initiate prompt reperfusion therapy if needed. This saves myocardial tissue from further damage.
Improved Outcomes: Numerous clinical studies have linked the availability and use of POCT to reduced time-to-treatment, lower mortality rates post-heart attack, decreased length of stay in emergency departments, and overall better outcomes for acute cardiac patients.
Increased Diagnostic Confidence: Rather than waiting hours for central lab test results, physicians gain assurance from being able to evaluate actual biomarker quantities at the patient's bedside or exam room. This allows for rapid rule-in or rule-out of acute coronary syndromes.
Improved Workflow: By eliminating turnaround delays for test send-out, cardiac POCT fully integrates into the workflow of busy emergency departments, chest pain units, and cardiac catheterization labs. Clinicians save time without compromising quality of care.
Earlier Discharge or Admit Decisions: The rapid biomarker information made possible by POCT permits same-day discharge for low-risk patients or swift transfer to coronary care units for high-risk scenarios like evolving heart attack, thus maximizing bed availability.
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