Application Of Cardiac Troponin I Assay Based On POCT In Patients With Emergency Chest Pain

Chest pain is a common emergency in the emergency department,the incidence is increasing year by year and there is a trend of younger.A variety of diseases can cause chest pain,and studies have shown that acute coronary artery complex accounts for the largest proportion of chest pain in emergency,and the risk degree of chest pain varies greatly among different causes.Fatal chest pain,such as acute coronary syndrome,aortic dissection,acute pulmonary embolism,and pericardial tamponade,may lead to sudden death at any time.Rapid diagnosis and early intervention of chest pain patients is the focus and difficulty of emergency work.Myocardial troponin is a biomarker commonly used in clinical identification of chest pain,but the laboratory test takes a long time,which affects the rapid clinical diagnosis and identification,leads to the retention of some emergency patients with chest pain,delays the timely treatment of patients,and increases the risk of emergency diagnosis and treatment.In view of this,We hope to quickly and safely identify the etiology of patients with emergency chest pain through the detection of myocardial troponin I based on point-of-care testing,so that they can obtain timely treatment and improve the prognosis of patients.Objective:By analyzing the application of Point-Of-Care Testing(POCT)in the determination of Cardiac Troponin I(cTnI)in patients with emergency chest pain,this study explored the clinical application value of cTnI detection based on POCT for patients with acute chest pain in the emergency department.Methods:A retrospective analysis was performed on 424 patients with acute chest pain admitted to the Emergency Department of the First Hospital of Qinhuangdao City from January 2020 to December 2020.According to POCT or not,the patients were divided into experimental group and control group,there were 212 cases in the experimental group and 212 cases in the control group.Sensitivity and specificity of patients in the experimental group and the control group in the diagnosis of Acute Myocardial Infarction at first cTnI were calculated,the receiver operating characteristic curve was drawn,and the area under ROC curve was calculated.The diagnostic value of cTnI in emergency AMI was compared between the two methods,and the optimal critical value was calculated.Meanwhile,cTnI value,specimen detection time,emergency stay time,incidence of emergency cardiovascular adverse events,prognosis and other indicators were compared between the two groups.P<0.05 was considered to be statistically significant.Results:1.General information:There were no significant differences in general information(gender,age,hypertension,diabetes,hyperlipidemia,smoking history,drinking history,body mass index,and duration of chest pain)between the two groups(P>0.05);2.Diagnostic efficacy:Compared with the control group,there was no significant difference in sensitivity and specificity of the experimental group(P>0.05).AUC of experimental group[0.967(95%CI:0.943-0.990)vs.0.976(95%CI:0.957-0.996),P>0.05]showed no statistical significance;3.Key index:compared with control group,cTnI value of experimental group[(0.051(0,1.738)ng/ml vs.(0.04(0,0.498)ng/ml,P>0.05],the difference was not statistically significant;The test time of the experimental group was significantly shortened[(76.76±16.18)min vs.(17.05±1.61)min,P<0.05],and the difference was statistically significant.The duration of emergency stay in the experimental group was significantly shortened[(93.03±15.65)min vs.(30.37±3.84)min,P<0.05],and the difference was statistically significant.The incidence of emergency cardiovascular adverse events in the experimental group was significantly shortened[14(6.6%)vs.5(2.4%),P<0.05],and the difference was statistically significant;4.Hospitalization index:Compared with AMI patients in control group,the hospital stay of AMI patients in the experimental group was not statistically significant[(8.9±1.6)d vs.(9.3±1.7)d,P>0.05].The treatment cost of AMI patients in the experimental group[14561(9870.5,18500)yuan vs.13568(9625,17158)yuan,P>0.05],the difference was not statistically significant;5.Prognostic index:Compared with AMI patients in control group,the incidence of cardiovascular adverse events in the experimental group 30 days after discharge was decreased[16(14.5%)vs.6(6.1%),P<0.05],and the difference was statistically significant.Conclusions:The determination of cTnI based on POCT is rapid and effective in the clinical diagnosis and differentiation of acute chest pain,which can significantly shorten the time of patient sample detection,emergency stay time,reduce the incidence of cardiovascular adverse events,improve the prognosis of patients,and has a high value in the clinical application of acute chest pain.