Troponin T with the cobas h 232 POC system

For faster triaging of patients with suspected Acute Myo cardial Infarction (AMI)

Use POC cTnT ≥ 50 ng/L to identify patients with suspected AMI at high risk of mortality

In the preHAP study, patients at the pre- hospital stage with suspected AMI and POC cTnT ≥ 50 ng/L:11
Had 3 –10 × higher long-term mortality risk, irrespective of AMI11
Required direct delivery to coronary intensive care or cath lab for medical investigation

Long-term mortality risk of patients with suspected AMI11

Fast triage of patients with suspected AMI at high risk of mortality

Triage patients faster

ESC guidelines recommend an early invasive strategy (within 24 hours) for patients with high-risk NSTEMI.10
POC cTnT ≥ 50 ng/L ensures quick and adequate triage of those high-risk patients in pre-hospital and emergency department settings.5,11
In the STEMI I study, patients with POC cTnT ≥ 50 ng/L, in the pre-hospital phase or at hospital admission, and subsequent triage as STEMI-like, were associated with earlier revascularisation and shorter hospital stay,
The troponin values have to be used in conjunction with full clinical assessment including ECG and clinical symptoms. NSTEMI: non-ST-segment elevation myocardial infarction, STEMI: ST-elevation myocardial infarction POC cTnT: POC Troponin T

Available tests

The cobas h 232 POC system allows rapid and easy determination of Troponin T, NT-proBNP, D-Dimer, CK-MB and Myoglobin in different settings, like ambulances, general practitioner offices and emergency rooms.

Test	Measuring range	Time to result	Clinical utility
Troponin	40 – 2,000 ng/L	12 min	Early aid in diagnosis of acute myocardial infarction and identification of patients with an elevated mortality risk4
NT-proBNP	60 – 9,000 pg/mL	12 min	Aid in diagnosis of patients with suspected heart failure, in monitoring of patients with compensated left ventricular dysfunction and in the risk stratification of patients with acute coronary syndromes5
CK-MB	1.0 – 40 ng/mL	12 min	Aid in diagnosis of patients with suspected acute myocardial infarction (AMI, heart attack), assessment of the size of the infarction and detection of re-infarction1
D-Dimer	0.1 – 4.0 µg/mL	8 min	Aid in exclusion of deep venous thrombosis and pulmonary embolism2
Myoglobin	30 – 700 ng/mL	8 min	Aid in diagnosis of patients with suspected myocardial infarction, reperfusion control3

References

1 Bertsch, T. et al. (2010). Clin Lab. 56(1-2), 37-49.
2 Roche (2016). cobas h 232 POC system Operator’s Manual, Version 6.0.
3 Roche CARDIAC D-Dimer-Method Sheet-package insert.
4 Roche CARDIAC proBNP-Method Sheet-package insert.
5 Roche CARDIAC POC Troponin T-Method Sheet-package insert.
6 Roche CARDIAC CK-MB-Method Sheet-package insert.
7 Roche CARDIAC M-Method Sheet-package insert.
8 Konstantinides, S. et al. (2014). Eur Heart J 35, 3033-3080.
9 Ponikowski, P. et al. (2016). Eur J Heart Fail 18(8), 891-975.
10 Roffi , M. et al. (2015). Eur Heart J 37(3), 267-315.
11 Stengaard, C. et al. (2013). American J Cardiol 112(9), 1361-1366.
12 Achar, S.A. et al. (2005). Am Fam Physician 72(1), 119-126.
13 Jungbauer, C. et al. (2017). Clin Lab 63(4), 633-645.
14 De Bastos, M.M. et al. (2008). Blood Coagul Fibrinolysis 19(1),
48–54.
15 Wells, P.S. et al. (2003). N Engl J Med 349(13), 416-420.
16 Berliner, D. et al. (2016). Dtsch Arztebl Int 113(49), 834-845.
17 Taylor, C.J. et al. (2017). Br J Gen Pract. 67(655), e94-e102.
18 Taylor, C.J. et al. (2017). Effi cacy and Mechanism Evaluation, No. 4.3. National Institute for Health. Research. ISSN 2050-4365. [Accessed September 2018].
19 British Heart Foundation and the All-Party Parliamentary Group on Heart Disease (2016). Focus on Heart Failure. Report accessible on https://www.bhf.org.uk/get-involved/campaigning/inquiry-
intoliving-with-heart-failure [Accessed September 2018].
20 Januzzi, J.L. et al. (2006). Eur Heart J 27(3), 330-337.
21 Januzzi, J.L. et al. (2018). J Am Coll Cardiol 71(11), 1191-1200.
22 Masson, S. et al. (2008). J Am Coll Cardiol 52, 997-1000.
23 DeBeradinis, B., Januzzi, J.L. (2012). Curr Opin Cardiol 27(6):
661-668.
24 Chiong, J. (2010). Heart Fail Rev. 15(4), 275-291.
25 Weiner, R. (2012). Eur J Heart Fail 15(3), 342-351.
26 Januzzi (2012). Arch Cardiovasc Dis. 105(1), 40-50.
27 Januzzi, J.L. et al. (2016). Clin Chem 62(5), 663-665.
28 Stengaard, C. et al. (2016). European Heart Journal: Acute Cardiovascular Care, 1-10.

cobas h232 Troponin T

Troponin T with the cobas h 232 POC system

For faster triaging of patients with suspected Acute Myo cardial Infarction (AMI)

Use POC cTnT ≥ 50 ng/L to identify patients with suspected AMI at high risk of mortality

Long-term mortality risk of patients with suspected AMI11

Fast triage of patients with suspected AMI at high risk of mortality

Triage patients faster

Available tests

Test

Measuring range

Time to result

Clinical utility

Troponin

NT-proBNP

CK-MB

D-Dimer

Myoglobin

References

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