We have been providing a 'routine' Troponin I assay in the Immulite 2000 for
at least two years. Assays are carried out on a regular basis during the
working day - sample tubes being colour coded to provide 'priority' . At
weekends, the assay is carried out on Saturday pm and Sunday pm. Attempts
to follow precise timings such as those used by John O'Connor have not
proved successful - but in general the post chest pain time - related in
many cases to admission time - is eight hours.
In addition, the Admissions Ward have a Roche Cardiac Reader, measuring
Troponin T on whole (lithium heparin) blood funded form non laboratory
sources. The assays are undertaken by senior nursing and junior medical
staff with the laboratory providing a weekly visit to include qc evaluation.
This can be used when the routine laboratory service is not available and at
night and other times when urgent results are required. Correlation has
been undertaken between the two assays .
Here, clinical definition of MI is based on a - classic - combination of
clinical and biochemical findings. Has the addition of Troponin results
helped? The jury here is still out - but if for any reason the assay is not
available - the requests for CK-MB (no longer offered) appear.
John Fry
Worthing
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