Troponin testing: an audit in three metropolitan hospitals

Med J Aust. 2003 Jul 21;179(2):81-3. doi: 10.5694/j.1326-5377.2003.tb05440.x.


Objective: To audit the appropriateness of use of a troponin I assay in three hospitals.

Design: Cross-sectional survey of use of a troponin assay.

Setting: Three hospitals in Melbourne, Victoria, each with an emergency department and a coronary care unit.

Participants: Patients for whom a troponin I assay was requested between 1 and 7 May 2002, 27-42 months after introduction of the assay.

Interventions: User-focused dissemination of relevant information, including protocols for use, from opinion leaders when the assay was introduced; continuous reinforcement of information in pathology reports.

Main outcome measures: Adherence to protocol for assay use.

Results: Troponin assays were requested for 333 patients during 351 symptom episodes. A single assay was used in 194 symptom episodes (55%), and serial assays in 157 (45%); proportions were statistically indistinguishable across all three hospitals (chi(2); P = 0.71). Of the 194 single assays, 13 (7%) diagnosed a myocardial infarction. Serial troponin testing in all three hospitals followed the suggested protocol, with mean time between serial assays being more than 6 hours at all hospitals.

Conclusions: Adherence to the protocol for serial troponin assay intervals was adequate, but single troponin assays were used extensively and probably inappropriately.

MeSH terms

  • Biological Assay / statistics & numerical data*
  • Cross-Sectional Studies
  • Guideline Adherence / statistics & numerical data*
  • Hospitals, Urban / statistics & numerical data*
  • Humans
  • Medical Audit / statistics & numerical data*
  • Myocardial Infarction / blood*
  • Myocardial Infarction / diagnosis
  • Myocardial Infarction / therapy
  • Outcome Assessment, Health Care / statistics & numerical data
  • Practice Patterns, Physicians' / statistics & numerical data
  • Time Factors
  • Troponin I / blood*
  • Victoria


  • Troponin I