Introduction of High-Sensitivity Troponin Assay to Rural Tertiary Care Medical Center: Impact on Subsequent Cardiac...

Area of Science:

• Cardiology
• Clinical Diagnostics
• Health Services Research

Background:

• High-sensitivity cardiac troponin (hs-cTn) assays improve myocardial infarction diagnosis but face slow adoption in the US, especially rural areas.
• Limited research exists on hs-cTn's impact on downstream testing in rural hospitals, where diagnostic delays are common.

Purpose of the Study:

• To evaluate the effects of transitioning from standard troponin assays to hs-cTn in a rural tertiary care medical center.
• To assess the impact on downstream cardiovascular testing, consults, and length of stay for chest pain encounters.

Main Methods:

• Retrospective analysis of de-identified data from a rural tertiary care center.
• Compared data from four weeks before and after hs-cTn assay implementation.
• Assessed downstream testing, consults, and length of stay for emergency department and inpatient chest pain cases.

Main Results:

• Chest pain complaints increased post-hs-cTn implementation (21.4% vs. 28.7%).
• A significant decrease in downstream stress tests was observed (aOR 0.55).
• Cardiac catheterization showed a non-significant trend toward decrease (aOR 0.57); lengths of stay remained similar.

Conclusions:

• hs-cTn implementation in a rural setting was associated with reduced downstream stress testing.
• No significant increase in other diagnostic procedures or cardiology consultations was noted.
• hs-cTn may optimize diagnostic pathways in rural hospitals without compromising care.