High sensitivity multiplex testing with a novel cardiac biomarker for rapid triage of acute chest pain patients enabling healthcare efficiencies and improved patient outcomes

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Acute myocardial infarctions (AMI/heart attacks) are one of the most common causes of death throughout the developed world. Each year ~720,000 UK citizens attend an emergency department (ED) with acute chest pain (ACP), representing ~6% of ED visits. Whilst the majority will not be suffering an AMI, due to the life-threatening nature of these symptoms, all patients must be monitored until successfully triaged. This places a huge strain on the NHS.The Gold Standard for ACP triage relies on assessment of clinical symptoms, electrocardiogram, and elevation/changes in troponin (cTn) biomarker levels (a marker of myocardial cell-death). Since most AMI patients display negative ECG symptoms, biomarkers play a crucial role ACP triage. However, cTn takes time to reach reliable measurable levels. This limits its usefulness for those presenting with early symptoms onset and requires cTn-levels to be monitored over time (a diagnostic pathway). Furthermore, cTn requires high-sensitivity testing (hs-cTn) undertaken in the hospital laboratory. These tests are slow restricting use to long (3-hr) diagnostic pathways. This results in an extended length-of-patient-stay, impacting on patient outcomes/experience and ED efficiency/productivity. Whilst point-of-care diagnostic devices are available, none can deliver reliable high-sensitivity testing.'Cardiac-Myosin-binding-protein-C' (cMyC) is an emerging myocardial necrosis biomarker. Unlike cTn, cMyC reaches elevated levels in the blood soon after AMI onset, improving diagnostic accuracy and enabling use with early presenters. However, cMyC levels fall equally as fast with time raising reliability concerns for late presenters. There are also barriers to clinical take-up, requiring clinicians to move from the trusted Gold Standard of cTn, or pay for additional testing.Osler seek to overcome these challenges through the application of a novel point-of-care diagnostic platform for the cost-efficient and reliable, simultaneously multiplexed, high-sensitivity testing of both cMyC and hs-cTn biomarkers.