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The usage patterns of cardiac bedside markers employing point-of-care testing for troponin in non-ST-segment elevation acute coronary syndrome: results from CRUSADE.

Publication ,  Journal Article
Takakuwa, KM; Ou, F-S; Peterson, ED; Pollack, CV; Peacock, WF; Hoekstra, JW; Ohman, EM; Gibler, WB; Blomkalns, AL; Roe, MT
Published in: Clin Cardiol
September 2009

BACKGROUND: Point-of-care (POC) testing may expedite the care of emergency department (ED) patients suspected of having acute coronary syndromes (ACS). We evaluated the use patterns of cardiac bedside markers or POC testing for troponin in patients with non-ST-segment elevation (NSTE) ACS. METHODS: NSTE ACS data were collected from the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology/American Heart Association (ACC/AHA) Guidelines (CRUSADE) registry. We compared hospital and patient characteristics, in-hospital events, and process-of-care variables between hospitals to those that did not use POC testing in > or = 50% of enrolled patients. We examined characteristics, in-hospital events, and process-of-care differences between patients with negative vs positive troponin POC testing results. RESULTS: Of 568 hospitals, 74 (16,276 patients) had high POC usage compared with 197 hospitals (50,782 patients) with no troponin POC usage. From the high POC usage hospitals, 12,604 patients had recorded troponin POC test results. Hospitals with high POC usage had a shorter ED length of stay and were less likely to administer aspirin, beta-blockers, and heparin during the first 24 hours of care. Patients with positive troponin POC results were more often older, minority, female, Medicare-insured, diabetic, and renally impaired. They had fewer electrocardiograms within 10 minutes but were more likely to get aspirin, beta-blockers, glycoprotein IIb/IIIa inhibitors, and heparin within 24 hours of arrival. They also had longer ED lengths of stay, received fewer in-hospital and interventional procedures, and had more adverse clinical events. CONCLUSION: Differences existed in how hospitals used POC testing and the care given based on those results. Positive POC results are associated with expedited and higher use of anti-ischemic therapies.

Duke Scholars

Published In

Clin Cardiol

DOI

EISSN

1932-8737

Publication Date

September 2009

Volume

32

Issue

9

Start / End Page

498 / 505

Location

United States

Related Subject Headings

  • United States
  • Troponin
  • Treatment Outcome
  • Time Factors
  • Retrospective Studies
  • Registries
  • Predictive Value of Tests
  • Practice Patterns, Physicians'
  • Point-of-Care Systems
  • Outcome and Process Assessment, Health Care
 

Citation

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MLA
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Takakuwa, K. M., Ou, F.-S., Peterson, E. D., Pollack, C. V., Peacock, W. F., Hoekstra, J. W., … Roe, M. T. (2009). The usage patterns of cardiac bedside markers employing point-of-care testing for troponin in non-ST-segment elevation acute coronary syndrome: results from CRUSADE. Clin Cardiol, 32(9), 498–505. https://doi.org/10.1002/clc.20626
Takakuwa, Kevin M., Fang-Shu Ou, Eric D. Peterson, Charles V. Pollack, W Frank Peacock, James W. Hoekstra, E Magnus Ohman, W Brian Gibler, Andra L. Blomkalns, and Matthew T. Roe. “The usage patterns of cardiac bedside markers employing point-of-care testing for troponin in non-ST-segment elevation acute coronary syndrome: results from CRUSADE.Clin Cardiol 32, no. 9 (September 2009): 498–505. https://doi.org/10.1002/clc.20626.
Takakuwa KM, Ou F-S, Peterson ED, Pollack CV, Peacock WF, Hoekstra JW, et al. The usage patterns of cardiac bedside markers employing point-of-care testing for troponin in non-ST-segment elevation acute coronary syndrome: results from CRUSADE. Clin Cardiol. 2009 Sep;32(9):498–505.
Takakuwa, Kevin M., et al. “The usage patterns of cardiac bedside markers employing point-of-care testing for troponin in non-ST-segment elevation acute coronary syndrome: results from CRUSADE.Clin Cardiol, vol. 32, no. 9, Sept. 2009, pp. 498–505. Pubmed, doi:10.1002/clc.20626.
Takakuwa KM, Ou F-S, Peterson ED, Pollack CV, Peacock WF, Hoekstra JW, Ohman EM, Gibler WB, Blomkalns AL, Roe MT. The usage patterns of cardiac bedside markers employing point-of-care testing for troponin in non-ST-segment elevation acute coronary syndrome: results from CRUSADE. Clin Cardiol. 2009 Sep;32(9):498–505.
Journal cover image

Published In

Clin Cardiol

DOI

EISSN

1932-8737

Publication Date

September 2009

Volume

32

Issue

9

Start / End Page

498 / 505

Location

United States

Related Subject Headings

  • United States
  • Troponin
  • Treatment Outcome
  • Time Factors
  • Retrospective Studies
  • Registries
  • Predictive Value of Tests
  • Practice Patterns, Physicians'
  • Point-of-Care Systems
  • Outcome and Process Assessment, Health Care