AIHTA - Publications - Search - Point of Care Tests (POCT): D-Dimer and Troponin

Huic, M. and Erdos, J. and Wild, C. (2024): Point of Care Tests (POCT): D-Dimer and Troponin. HTA-Projektbericht 124/ 1. Update.

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Background: Point of care tests (POCTs) for troponin (Tn) and D-Dimer enable rapid diagnostics near patients. Tn-POCTs are used when there is a suspicion of acute coronary syndrome (ACS) and D-Dimer-POCTs are used when there is a suspicion of venous thromboembolism (VTE).

Objectives: The aim of this report, which is an update of a review conducted in 2019, is to answer the following questions: What is the clinical benefit of D-Dimer-POCT and Tn-POCT in the treatment of symptomatic adults in primary care?

Methods: A systematic literature search was conducted in four databases for systematic reviews (SR), health technology assessments (HTAs) and primary studies. Additionally, a hand search for guidelines and ongoing studies was conducted. Two independent researchers carried out the study selection, data extraction and control, and risk of bias assessment.

Results: Tn-POCT: Three studies (one RCT and two observational studies) were identified. In the RCT, the 30-day and 1-year incidence of major adverse cardiac events (MACE) was low and comparable between the pre-hospital rule-out and emergency department rule-out strategies. The two observational studies showed no MACE within 30 days among low-risk patients. The RCT showed no significant difference in quality of life. The pre-hospital rule-out strategy significantly reduced unnecessary emergency department visits without affecting the number of hospital admissions. The diagnostic accuracy of the prehospital strategy was comparable to that of the emergency department. None of the studies evaluated high-sensitivity (hs)-Tn-POCT.
D-Dimer-POCT: Three observational studies assessed the combination of D-Dimer-POCTs with clinical decision rules but showed methodological weaknesses and poor correlation between capillary and plasma measurements.

Discussion: The evidence on the clinical utility of hs-Tn-POCTs and quantitative D-dimer POCTs in primary care is still limited. No new SRs or HTAs were found.

Conclusion: Further high-quality and larger studies are necessary to confirm the clinical utility of single-time-point fingerstick measurement of hs-Tn-POCTs and quantitative D-dimer POCTs in primary care.

Item Type:Project Report
Keywords:Point of care, troponin, D-Dimer, diagnostic tests
Subjects:QU Biochemistry > QU 55-70 Proteins. Amino Acids. Peptides
WB Practice of medicine > WB 105 Emergency medicine
WB Practice of medicine > WB 141-293 Diagnosis
WG Cardiovascular system
WX Hospitals and other health facilities > WX 200-225 Clinical departments and units
Series Name:HTA-Projektbericht 124/ 1. Update
Deposited on:27 Jun 2024 10:50
Last Modified:27 Jun 2024 10:50

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