Raccomandazioni del Gds-MM siPMeL per l’implementazione di point-of-care testing di troponina per la diagnostica delle sindromi coronariche acute aggiornamento 2024

Introduction: The Working Group on Myocardial Markers of the Italian Society of Clinical Pathology and Laboratory Medicine (GdS-MM SIPMeL) issued in 2016 Recommendations on implementation of Point-of-care testing (POCT) of troponin (cTn) for the diagnosis of Acute Coronary Syndromes (ACS). The aim of the present research is to establish whether the Recommendations are still valid in light of the evidence produced in the last 8 years. Evidence acquisition: Searches was carried out in PubMed (systematic review, SR) and in the websites of the main Scientific Laboratory Societies, CLSI and ISO, for key events, Laboratory Medicine Guidelines (LGLM), and standard of practice and accreditation involving POCT cTn in the last 8 years. Evidence synthesis: The SR produced 24 articles: 15 on hs-cTn POCT in common use (1 TriageTrue, 3 PATHFAST, 11 Atellica VTLi), 6 reviews on POCT hs-cTn, and 3 IFCC Recommendations. Bibliographic research and consultation of the main websites of Scientific Laboratory Societies did not return any LGLM specifications on POCT cTn but only general POCT guidelines. The visit to the ISO and CLSI sites returned important standards for POCT but not specific for POCT hs and non-hs cTn. The key events for the update of the LGLM on POCT cTn are the introduction in the market of POCT hs-cTn and the related scientific evidence. Conclusions: In light of the technological innovations and the following scientific evidence, it is necessary to update our LGLM on the implementation of POCT hs and non-hs cTn, not so much for the general and governance aspects, but for operational aspects (devices, methods, sample, quality assurance, turnaround time, connectivity, oversight).