![]() There are innovative wearable devices based on functional-near-infrared light interrogation 14 such as, cortical hemodynamics 15, blood oxygenation 16, blood glucose monitoring 17, etc. The most appealing aspects include the benefit of minimal or no sample preparation required. Posited in this letter as a solution is infrared spectroscopy 13, a widely used and applied characterization technique due to its ability to probe into the material at the molecular level and hence an inherently sensitive mode of interrogation. While the recent POC 12 solutions reduce time to test results, there still remains a dependency on blood draw coupled with lower analytical sensitivity compared to central laboratory testing, hence limiting their application toward effective discharge from the ED. Similarly, recent developments with microneedle patches 11 further demonstrate promise for longitudinal monitoring of the levels of inflammatory biomarkers. High sensitivity immunoassays have advanced state of art possibilities for point of care and home healthcare modalities with innovations by startups like Luminostics 10. Point-of-care (POC) assays are becoming increasingly available such as Abbott iSTAT 8 but suffer from low sensitivity making them incompatible with rapid rule-out algorithms 9. Furthermore, it mandates the logistics between physician and laboratory. While immunoassays are highly developed and accurate, extensive sample preparation including cumbersome blood 7 draws are required. The state-of-the-art 4 troponin quantitation mechanism is based on immunoassays 5 involving the use of two or more antibodies, one of which is labeled, typically with a chemiluminescent tag, which adds another level of complexity 6 in the analysis. Therefore, the development of new technologies that can allow early non-invasive detection of myocardial injury is imperative.ĭetection of cardiac troponins 3 to assess cardiac injury has been around since the 1990s. Furthermore, 1 out of 5 myocardial infarctions (MI) is asymptomatic (silent), leading to nearly 200,000 silent MIs each year in the US 2. Over 80% of these are due to non-cardiac causes, resulting in an unnecessary burden in the ED, revealing the need for an instant non-invasive screening technique that can streamline the ED workflows 1. Over 10 million patients present with chest pain 1 in emergency departments (ED) in the United States alone. Further, potential pitfalls associated with infrared spectroscopic mode of inquiry are outlined including requisite steps needed for improving the precision and overall diagnostic value of the device in future studies. This preliminary work introduces the potential of a bloodless transdermal measurement of troponin-I based on molecular spectroscopy. We demonstrate a significant correlation ( r = 0.7774, P < 0.001, n = 52 biologically independent samples) between optically-derived data and blood-based immunoassay measurements with and an area under receiver operator characteristics of 0.895, sensitivity of 96.3%, and specificity of 60% for predicting a clinically meaningful threshold for defining elevated Troponin I. ![]() ![]() Patients were recruited with suspected acute coronary syndrome. Our device relies on infrared spectroscopic detection of troponin-I through the dermis and is tested in stepwise laboratory, benchtop, and clinical studies. In this communication, we present the development and early validation of non-invasive transdermal monitoring of cardiac troponin-I to detect its elevated state. This modality further restricts the number of measurements given the clinical context of the patient. Current standard-of-care troponin assays provide a snapshot or momentary view of the levels due to the requirement of a blood draw. The levels of circulating troponin are principally required in addition to electrocardiograms for the effective diagnosis of acute coronary syndrome.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |