Our experience of this has been good. Since the hospital was downgraded to a Diagnostic and Treatment centre, with no A&E, and patients being expected to travel 18 miles to the nearest A&E, our GP's have been using the Troponin service quite extensively.
Obvious MI patients are fast-tracked to the acute site, but those with chest pains, and little else have Troponin T level as well as CK measured, and very few show raised Troponins T above 0.06. Most of the elevations are less than 0.2, with only a couple in two years having raised levels and been show as late presenting post MI.
So, I would recommend it's use in primary care, providing there is a clear understanding with the GP's about which patient's it should be used in, and an agreement that any patients with raised levels can be assessed quickly once the result is available, either by cardiologist, or at a one stop chest pain clinic.
Regards,
Gary
Gary Mascall (Consultant in Clinical Biochemistry)
Clinical Biochemistry Department
Kidderminster Hospital
Worcestershire Acute Hospitals NHS Trust
Tel : 01562 823424 Extn 53465
email : [log in to unmask]
-----Original Message-----
From: Williams David G (RLN) City Hospitals Sunderland - Clinical
Scientist [mailto:[log in to unmask]]
Sent: 08 December 2003 11:03
To: [log in to unmask]
Subject: Troponins from Primary Care
Picking up on a recent comment about requests for Troponins from Primary
Care being exceptional, what is the experience of other users?
Should a GP be able to use this test, or should the patient be referred to
the local cardiologists/CCU?
Dr David G Williams
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