The utility of point-of-care biomarkers as a prognostic tool for patients with acute coronary syndromes

Introduction. Patients with symptoms suggestive of acute coronary syndrome (ACS) have various medical backgrounds and different stages of underlying coro-nary disease. Hence, patients entering the emergency room (ER) with ACS sug-gestive symptoms, present a challenge to emergency physicians. We hypothesized that a point-of-care test (POCT) for mul-tiple cardiac biomarkers can be used as a prognostic tool for predicting severity and hospital mortality in acute myocardial in-farction (AMI) patients.

Methods . We conducted a retrospective analysis of all patients who presented to the ER of a university urban hospital with chest pain, chest discomfort and short-ness of breath of potential cardiovascular origin during a 3-year period. Biomarkers from the POCT and coronary angiography (CAG) results were used for diagnosis. Se-verity was evaluated based on involvement and status of major coronary arteries, ejec-tion fraction and in-hospital mortality. Results. Out of 1336 patients, 329 patients were diagnosed with AMI. Risk of major coronary artery occlusion was increased with an increased number of positive POCT findings. The percentage of patients with severe left ventricular dysfunction was higher in the group with 2 or 3 posi-tive POCTs than 0 or 1. As the number of positive POCTs increased from 1 to 3, our results showed an increment in the per-centage of in-hospital mortality Conclusions. This study identified the pos-sibility of a POCT as a prognostic tool. The POCT is easy to use by the bedside and can be checked relatively quickly? in a short period of time. If the POCT result is used to predict the prognosis in ACS patients, emergency physicians may approach pa-tients with more caution.

chest pain, shortness of breath, acute myocardial infarction, in-hospital mortality 

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