Introduction of High-Sensitivity Troponin Assay to Rural Tertiary Care Medical Center: Impact on Subsequent Cardiac Diagnostic Testing.

High-sensitivity cardiac troponin (hs-cTn) assay offers improved diagnostic accuracy for the detection of myocardial infarction but has seen slow adoption in the United States, particularly in rural settings. Limited research has explored the impact of hs-cTn implementation on downstream testing, in rural hospitals where diagnostic delays are common. This study evaluates the effects of transitioning from standard assay to hs-cTn in a rural tertiary care medical center. We conducted a retrospective analysis of de-identified data from four weeks before and after the implementation of an hs-cTn assay. We assessed the presence of downstream cardiovascular testing and consults among emergency department and inpatient chest pain encounters. Lengths of stay were evaluated. In total, 1664 pre- and 1479 post-implementation admissions were evaluated. Demographic characteristics and comorbidities were similar during the study period. Chest pain was reported more frequently during the post-hs-cTn implementation period as the chief complaint (21.4% vs. 28.7%;