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Efficiency of point-of-care Troponin-T testing in a Swedish primary care setting
Linköping University, Department of Medical and Health Sciences, General Practice. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Local Health Care Services in the East of Östergötland, East County Primary Health Care.
Linköping University, Department of Medical and Health Sciences, Cardiology. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Cardiology UHL.ORCID iD: 0000-0002-9375-5087
Department of Internal Medicine, Ryhov County Hospital, Jönköping, Sweden.
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2011 (English)Conference paper, Published paper (Other academic)
Abstract [en]

Rationale Swedish general practitioners and cardiologists are concerned of the use of point-of-care Troponin-T testing (PCTT) in primary care i.e. the risk of overlooking a recent acute myocardial infarction (AMI) or unstable angina (UA) relaying too much on a laboratory finding. In this study we aimed to evaluate both missed and properly managed AMI or UA in relation to the use of PCTT. Methods & Results Setting: Seven primary health care centres (PHCC) in southeast Sweden participated. In three of the PHCCs, PCTT was analysed in conjunction with clinical assessment of all study patients, i.e. PCTT-PHCCs. In four of the PHCCs, PCTT was not used, i.e. Control-PHCCs. All patients ≥ 35 years old consulting for chest pain, having commenced or aggravated the last seven days, were included in the study. A systematic review of hospital medical records was done of all patients hospitalised the same day as inclusion or within 30 days there after. In patients who were sent home from the PHCC and hospitalised for any reason within thirty days, the PHCC medical records were systematically reviewed, by one GP and one cardiologist. 196 patients were included, 128 patients in the three PCTT-PHCCs and 68 patients in the four Control-PHCCs. In the PCTT-PHCCs two patients were identified as missed AMI or UA and none in the Control-PHCCs. Properly managed patients with AMI or UA were five in the PCTT-PHCCs and six in the Control-PHCCs. Conclusion The use of PCTT in primary care does not seem to enhance a total safety manageing of chest pain patients. Clinical Relevance The use of PCTT in primary care could be discussed due to the risk of false safety.

Place, publisher, year, edition, pages
2011.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-76096OAI: oai:DiVA.org:liu-76096DiVA: diva2:512267
Conference
European Primary Care Cardiovascular Society 4th Annual Scientific Meeting, September 1-2, 2011, Berlin, Germany
Available from: 2012-03-27 Created: 2012-03-27 Last updated: 2013-09-11

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Nilsson, StaffanJanzon, MagnusBorgquist, Lars

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Nilsson, StaffanJanzon, MagnusBorgquist, Lars
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General PracticeFaculty of Health SciencesEast County Primary Health CareCardiologyDepartment of Cardiology UHLUnit of Research and Development in Local Health Care, County of Östergötland
Medical and Health Sciences

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CiteExportLink to record
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Citation style
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