CARDIAC MARKERS

Learning about the current use of cardiac markers to support critical decision making in the treatment of patients suspected of myocardial infarction.

The meeting was hosted by Lori Pettit and Susan Swanek both Quality Improvement/POCT specialists from the Geisinger Health System.  Lori began by stating some opening remarks and requested everyone to introduce themselves and state their POCT wish for Christmas.  The following is a condensed version of our wish list:

• Connectivity, Connectivity, Connectivity!!

• No exception results

• Standardization

• Compliance on the nursing floors

• ERs in compliance

• More time to do POCT

• Nurses to label all vials appropriately

• More chances to network and learn from one another

We had the distinguished pleasure of hearing about cardiac markers from Dr. Laurence M. Demers, PhD., DABCC, FACB who is a Professor of Pathology and Medicine and the Director of Clinical Chemistry, Central Processing, Core Endocrinology Laboratory and the Automated Testing Laboratory at the Penn Ste University, Milton S. Hershey Medical Center.

Dr. Laurence M. Demers

Dr.  Demers gave us an in-depth view of cardiac markers.  Some of the highlights he emphasized include information on the evolving process of myocardial Infarctions by determining what elements help to make a diagnosis.  He discussed the stand the AHA has made on determining an MI.  He discussed the idea behind early detection and how important the first 4-6 hours are after an episode.  He mentioned therapies for MI and unstable angina.  He discussed the ERs role in diagnosis and the fact that chest pain evaluation, ECG and markers are essential. 

Troponin therapy of either I or T types was the next area of discussion.  Dr. Demers talked about the current state of specificity of these markers and that the next generations need to be even more sensitive in the early hours.  He stressed the need for very rapid TAT to properly diagnose the MI.  POCT and the troponin cardiac markers was the next area of discussion. Dr. Demers showed us statistics reflecting the increase in the use of cardiac markers from 1999 to 2000.  Not only is the ER using these markers, but the OR, Stat Labs and OPD departments are as well. 

The last topic discussed was that of the CRP and its role as a prognostic marker of CHD and how it can help with clinical management.   There were a lot of great questions and the group felt very informed about cardiac markers in general and what’s to come down the road for POCT.

Dade Behring

Mike Haus from Dade Behring presented some interesting statistics about the Status-CS cardiac marker instrument his company sells.  He gave us each a packet which included several pieces of literature telling of the instrument functionality.  Many thanks to Dade Behring for proving lunch for the KEYPOCC group!

Future

Lori Pettit then lead our discussion on the 2001 KEYPOCC meetings:

We elected a new Treasurer:  Beverly McAllister from Ephrata who will collect the $25 annual fee we decided upon for the year 2001.  This membership fee will help offset some of the costs Hershey currently swallows.  This fund could help pay for AV rental/stationary/postage/speakers etc. Any guests who did not pay the $25 annual fee can pay a $10/meeting.  More information on this will be sent out within the next month.

  The new secretary for 2001 is Marcy Anderson.  Any late comers to the next meeting will automatically be appointed this important task. 

The topic for the next meeting is New/Non-invasive technology for the future.  Several individuals are researching this and getting back to Mary Ann from Chambersburg.