%0 Journal Article
%T Predictive value of routine point
%A Carsten Stengaard
%A Christian J Terkelsen
%A Claus-Henrik Rasmussen
%A Hans E Bˋtker
%A Ingunn S Riddervold
%A Jacob T Sˋrensen
%A Martin B Rasmussen
%A Matthias Giebner
%A Troels M Hansen
%J European Heart Journal: Acute Cardiovascular Care
%@ 2048-8734
%D 2019
%R 10.1177/2048872617745893
%X The purpose of this study was to determine the predictive value of routine prehospital point-of-care cardiac troponin T measurement for diagnosis and risk stratification of patients with suspected acute myocardial infarction. All prehospital emergency medical service vehicles in the Central Denmark Region were equipped with a point-of-care cardiac troponin T device (Roche Cobas h232) for routine use in all patients with a suspected acute myocardial infarction. During the study period, 1 June 2012每30 November 2015, prehospital point-of-care cardiac troponin T measurements were performed in a total of 19,615 cases seen by the emergency medical service and 18,712 point-of-care cardiac troponin T measurements in 15,781 individuals were matched with an admission. A final diagnosis of acute myocardial infarction was confirmed in 2187 cases and a total of 2150 point-of-care cardiac troponin T measurements (11.0%) had a value ≡50 ng/l, including 966 with acute myocardial infarction (sensitivity: 44.2%, specificity: 92.8%). Patients presenting with a prehospital point-of-care cardiac troponin T value ≡50 ng/l had a one-year mortality of 24% compared with 4.8% in those with values <50 ng/l, log-rank: p<0.001. The following variables showed the strongest association with mortality in multivariable analysis: point-of-care cardiac troponin T≡50 ng/l (hazard ratio 2.10, 95% confidence interval: 1.90每2.33), congestive heart failure (hazard ratio 1.93, 95% confidence interval: 1.74每2.14), diabetes mellitus (hazard ratio 1.42, 95% confidence interval: 1.27每1.59) and age, one-year increase (hazard ratio 1.08, 95% confidence interval: 1.08每1.09). Patients with suspected acute myocardial infarction and a prehospital point-of-care cardiac troponin T ≡50 ng/l have a poor prognosis irrespective of the final diagnosis. Routine troponin measurement in the prehospital setting has a high predictive value and can be used to identify high-risk patients even before hospital arrival so that they may be re-routed directly for advanced care at an invasive centre
%K Acute myocardial infarction
%K prehospital triage/methods
%K cardiac troponin
%K emergency medical services
%K point-of-care
%U https://journals.sagepub.com/doi/full/10.1177/2048872617745893