Hi Swami2
Most people do not have chest pain in front of the ED.
They sit at home denying there is a problem, thinking it is indigestion or a strained muscle or something else.
By the time they call in to see someone it is generally some time after onset of symptoms starting.
I understand your point around 'ruling out' although where I think the advantage is with a finger prick lab sensitive 5 minute test is to 'rule in' and get the patient into the Cath lab ASAP.
The troponin levels should keep rising for the first 6 hours.
Thus the repeat testing to establish the rule out.
The higher the sensitivity of the testing then the greater chance of detecting fluctuations to rule out.
I know it is a bit old but try looking at this 2012 article that is looking at a 1 hour retest with a high sensitive troponin test. But with a TAT of 1 hour I wonder what the use is.
http://archinte.jamanetwork.com/Mobile/article.aspx?articleid=1309579
There are health services who now have an accelerated pathway of 2 hour testing to try and get people out of ED.
Anyway it's a nice day to top up
Chart, page-63
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