Point-of-care testing for cardiac markers in acute coronary syndromes and heart failure.

Advances in technologies for immunoassay testing have enabled the development of 15-minute whole-blood assays for cardiac markers in the evaluation of patients with acute coronary syndromes (ACS) and congestive heart failure. In many cases, the analytical performance of these assays is equivalent to that of testing in the central laboratory. Rapid whole-blood point-of-care assays for troponin, creatine kinase isoenzyme CK-MB, myoglobin, and B-type natriuretic peptides have facilitated efforts to restructure conventional approaches to ACS and heart failure in the emergency room. Improvements in outcomes, including decreased emergency room and hospital length-of-stay, decreased overall cost, and earlier discharge of low-risk patients, have been documented following implementation of these technologies.