In the US, there are more than 8 million visits to emergency departments (EDs) annually for chest pain or other symptoms consistent with acute coronary syndrome (ACS) that includes acute myocardial infarction (AMI) or heart attack.
The challenge to clinicians is rapid identification of those who require admission for urgent management and those with a benign cause who can be discharged directly from the ED. Likewise, ACS outcomes depend strongly on time-dependent intervention and therapies; indeed, time is muscle for the ACS patient and the attending ED physician. Recent guidelines by the American College of Cardiology and the American Heart Association for the diagnosis and treatment of ACS recommend that cardiac markers should be evaluated within 30-60 minutes from the time of ED presentation. Many EDs and central laboratories do not meet this recommendation, as processing of samples in these environments includes transport of blood from the ED to the lab, extraction of serum (via clotting), centrifugation and long assay times (at best 20 minutes if an automated immunoassay analyzer is used).
Point of care (POC) devices, as developed in the McDevitt lab, address this demand for accelerated diagnostic information and reduction in result turn-around-times (TATs). POC tests are attractive because they can be performed simply, outside the laboratory without the requirement for highly trained personnel and quickly, offering swift TAT of results. POC tests provide a means for reducing hospital stay and complications, as well as help accelerate the application of life saving treatments. Further, POC tests can be performed in the ED setting negating the need of sample transportation to a central laboratory and, thereby, reducing the risk for sample degradation, thus allowing for a more accurate diagnosis.