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

急性心肌梗死（AMI/心脏病发作）是发达国家最常见的死亡原因之一。每年约有72万名英国公民因急性胸痛（ACP）进入急诊科（ED），占急诊科就诊人数的6%。虽然大多数人不会患上急性心肌梗塞，但由于这些症状的危及生命的性质，所有患者都必须接受监测，直到成功分诊。这给NHS带来了巨大的压力。ACP分诊的金标准依赖于临床症状、心电图和肌钙蛋白（cTn）生物标志物水平（心肌细胞死亡的标志）的升高/变化的评估。由于大多数AMI患者表现为阴性心电图症状，生物标志物在ACP分诊中起着至关重要的作用。然而，cTn需要时间才能达到可靠的可测量水平。这限制了它对那些出现早期症状的人的有用性，并且需要长期监测ctn水平（一种诊断途径）。此外，cTn需要在医院实验室进行高灵敏度测试（hs-cTn）。这些检测速度慢，限制了使用时间较长（3小时）的诊断途径。这导致患者住院时间延长，影响患者的治疗结果/体验和急诊科的效率/生产力。虽然有即时诊断设备，但没有一种可以提供可靠的高灵敏度检测。心肌肌球蛋白结合蛋白c （cMyC）是一种新兴的心肌坏死生物标志物。与cTn不同的是，cMyC在AMI发病后很快就会在血液中升高，从而提高了诊断的准确性，并使其能够用于早期患者。然而，随着时间的推移，cMyC水平下降的速度同样快，这引起了对迟到演讲者可靠性的担忧。临床应用也存在障碍，要求临床医生放弃值得信赖的cTn黄金标准，或者支付额外的测试费用。奥斯勒寻求克服这些挑战，通过一个新的点护理诊断平台的应用，成本效益和可靠，同时多路复用，高灵敏度的cMyC和hs-cTn生物标志物的测试。

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.