Capillary whole-blood hs-cTnI point-of-care testing demonstrated 92.1% overall agreement with central laboratory measurements at the 99th percentile threshold for suspected acute myocardial infarction.
Cross-Sectional (n=91)
No
Does capillary hs-cTnI POC sampling provide acceptable analytical agreement and clinical concordance compared to central laboratory measurement in adults with suspected AMI?
Capillary whole-blood hs-cTnI POC testing shows high clinical concordance with central laboratory measurements, supporting its use for rapid AMI assessment in resource-limited settings.
Effect estimate: κ >0.75
BACKGROUND: High sensitivity cardiac troponin I (hs-cTnI) assays are central to the early diagnosis and rule-out of acute myocardial infarction (AMI). In resource-limited settings, point-of-care (POC) platforms using capillary blood may reduce turnaround time and improve access to timely decision-making. This study evaluated the performance of capillary hs-cTnI POC sampling in an African population. METHODS: This cross-sectional method comparison study evaluated paired capillary hs-cTnI measurements obtained on POC against corresponding venous serum and plasma samples analysed on a central laboratory assay. Samples were collected from adults presenting with suspected AMI to Charlotte Maxeke Johannesburg Academic Hospital Emergency Department. Analytical verification was performed in accordance with Clinical and Laboratory Standards Institute protocols. Agreement was assessed using Bland Altman analysis. Diagnostic concordance at sex-specific 99th percentile decision thresholds and misclassification rates were determined. RESULTS: = 0.791; 95% CI 0.699-0.857). Mean bias of capillary versus plasma was -15.9% (-173% to +143%) and - 12.9% (-171% to +145%) compared with serum. Serum comparison met the predefined allowable minimum bias of 13.6%. Overall agreement at the 99th percentile was 92.1% (83/91), with substantial inter-method agreement (κ >0.75). No significant asymmetry in discordant classifications was observed (p = 0.7266; 95% CI -8.27 to 3.88). CONCLUSION: Capillary whole-blood hs-cTnI testing demonstrated acceptable analytical agreement and high clinical concordance with central laboratory measurement, supporting its implementation to enhance rapid AMI assessment in resource-limited emergency settings.
Ann et al. (Tue,) conducted a cross-sectional in Suspected acute myocardial infarction (n=91). Capillary hs-cTnI point-of-care testing vs. Central laboratory venous serum and plasma hs-cTnI assay was evaluated on Overall agreement at the 99th percentile decision threshold (κ >0.75). Capillary whole-blood hs-cTnI point-of-care testing demonstrated 92.1% overall agreement with central laboratory measurements at the 99th percentile threshold for suspected acute myocardial infarction.