WESTCOR-POC: Point-of-care hs-troponin testing increases emergency department efficiency

Point-of-care high-sensitivity troponin I (hs-cTnI) testing reduced the length of stay in the emergency department, with comparable safety as centralised hs-cTnI testing in the WESTCOR-POC trial. This improved efficiency of the emergency department is particularly relevant for patients with myocardial infarction (MI).

“Overcrowding is a common problem in emergency departments,” stated Dr Viola Thulin (Haukeland University Hospital, Norway) [1]. “This leads to longer waiting times, which is detrimental for patients who come in with MI.” The current randomised-controlled WESTCOR-POC trial (NCT05354804) compared point-of-care hs-cTnI testing at 0 and 1 hours to central laboratory hs-cTnI testing at 0 and 1 hours among 1,614 participants with symptoms suggestive of acute coronary syndrome. The primary endpoint was the length of stay at the emergency department.

A small but significant drop was seen in the duration of emergency department stay in the point-of-care testing group versus the control group (174 vs 180 min; P=0.024). “Given that this is a large proportion of the patients visiting the emergency department, this is still a relevant difference,” commented Dr Thulin. For patients who were seen by a physician within 60 minutes, the difference in duration of stay was more pronounced (147 vs 162 min; P<0.001) as was the difference in patients who had an acute MI (137 vs 180 min; P=0.005). “There were no differences with respect to the safety of the two procedures,” said Dr Thulin (see Table).

Table: No differences in safety outcomes [1]



AMI, acute myocardial infarction; CI, confidence interval.

“Our study showed that point-of-care hs-cTnl testing can reduce the length of stay in an emergency department,” concluded Dr Thulin. “However, the benefits from point-of-care hs-cTnl testing are dependent on local logistics and workflow.”

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   1. Thulin IVL, et al. Efficiency and safety of point-of-care high-sensitivity troponin in the emergency department. HOTLINE 12, ESC Congress 2024, 30 Aug–02 Sept, London, UK.

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Posted on 7 November 20247 November 2024