737–3 Rapid Whole Blood Bedside Cardiac Troponln T Immunoassay for the Diagnosis of Acute Myocardial Infarction

Cardiac troponin T (cTT) is a regulatory contractile protein normally not found in the blood. Its detection in the circulation has been shown to be a sensitive and specific marker for acute myocardial infarction (AMI). The Elisa cTT presently requires at least 90 minutes, which is too long to be useful in emergency situations.We tested a new rapid bedside whole blood immunoassay for cTT in 32 consecutive patients admitted to the Geneva University Hospital for suspected AMI, with an onset of pain within 12 hours. The new rapid assay, the Elisa cTT, the creatine kinase (CK) and creatine kinase-MB (CK-MB) were performed at admission, 4 and 8 hours after admission.The rapid assay was positive in all 25 patients subsequently shown to have an AMI. In the 7 patients without AMI, the assay was negative in 6, and positive in 1 (myopericarditis). At each time of the three measurements, the rapid assay had a similar or a better sensitivity and specificity than CK-MB or Elisa cTT. Already 4 hours after admission, the rapid assay reached a sensitivity of 100%, which is better than the CK-MB (96%).Results of the rapid assay were obtained in 15 minutes, even less in all positive cases, and the time to get a positive result correlated with the cTT Elisa and CK-MB levels.Our results allowed us to conclude that, while considerably more rapid than conventional assays, this new bedside whole-blood troponin T assay also has equal or better sensitivity and specificity than the other tests. In addition, we would like to stress the simplicity of this rapid assay, that can be performed on the spot, without laboratory infrastructure or equipment