Expanding the Use of Point-of-Care hs-cTnI in Emergency Primary Care: Insights from the OUT-POC Pilot Study – Authors’ Response Open Access

Dear Editor,

We appreciate Hoşoğlu’s [1] insightful observations regarding our research [2] and share their enthusiasm for its potential implications in emergency primary care. It is correctly noted that we did not include age, symptom characteristics, or risk factors in the interpretation of the 0/1-h algorithms as these are solely based on troponin values, the 1-h deltas, and symptom onset [3]. However, according to the European Society of Cardiology, the algorithms should be used in conjunction with the clinical examination and a 12-lead electrocardiogram [3]. Our study followed this approach, with troponin measurements guided by clinical judgment after initial evaluation [4]. The added value of POC testing integrated within various clinical risk scores will be explored in the next phase of the project [5].

We agree with Hoşoğlu that a larger study is highly needed, as described in the Discussion section [4]. In the upcoming project, we aim to enhance the robustness of our findings by including 2,500 patients from 6 urban and rural sites in Norway [5]. A larger sample size will allow us to investigate the true performance of the algorithm, also in early presenters.

Hoşoğlu also addresses relevant knowledge gaps that should be investigated, including patient-reported outcomes and the cost-effectiveness of such a strategy. We are happy to share that these suggestions have already been planned for the next phase of the project [5]. The burden of persistent chest pain and its impact on a patient’s quality of life, including psychological stress and anxiety, will be explored. We look forward to advancing this project to better evaluate the safety and effectiveness of the POC algorithm in emergency primary care.