Chest pain remains one of the most common and resource-intensive presentations in emergency care. Clinicians are often required to make rapid decisions in environments where patient volumes are high, and diagnostic delays can alter outcomes. Point-of-care troponin (Tn) testing has therefore become an important tool in acute settings, enabling faster rule-out of myocardial injury and earlier initiation of appropriate care pathways.

Contemporary POC troponin assays (cTnI, cTnT) gained routine adoption not simply for convenience, but because they improved confidence in frontline decision-making when central lab turnaround times were not aligned with the urgency of clinical need. As central laboratories increasingly transitioned to hsTn as the standard of care, the relative appeal of contemporary POC troponin (cTnI, cTnT) began to fade and a performance gap began to emerge.  While contemporary POC assays continued to support rapid triage, they could not consistently match the analytical sensitivity of laboratory-based high-sensitivity assays, particularly at lower concentrations critical for early rule-out decisions. Meanwhile, newly issued ESC and ACC/AHA guidelines continue to advocate broader use of hsTn for risk stratification, enabling faster rule-out and reducing reliance on downstream testing. However, translating these protocols into routine practice remains challenging. Many hospitals face constraints related to laboratory capacity, workflow redesign, and coordination between emergency and lab teams, which can limit the real-world impact of accelerated pathways. These operational pressures are increasing interest in solutions that can deliver reliable highly sensitive results closer to the patient, supporting faster clinical decision-making at the bedside. This is where the shift begins.

High-sensitivity troponin at the POC is more than just a diagnostic product upgrade. While POC Tn has been embedded in emergency care for years, the expansion of high-sensitivity testing in central laboratories had gradually shifted testing volumes back towards core lab workflows. The introduction of hsTn in decentralized settings is now reshaping how POC platforms are evaluated within chest-pain pathways, particularly in relation to clinical protocol alignment, turnaround expectations, and the evolving balance between lab and near-patient testing. In short, it’s not simply another assay launch, but a strategic turning point for the POC market.

The journey: Contemporary Troponin built the habit… high-sensitivity Troponin builds the decision

Over the past two decades, contemporary POC Tn has become a cornerstone of acute cardiac care due to the time-sensitive nature of myocardial infarction management. Rapid troponin testing enables clinicians to quickly confirm or rule out cardiac injury, allowing timely activation of cardiology intervention and reducing the risk of delayed treatment. In high-pressure emergency settings, near-patient testing has helped to overcome laboratory turnaround bottlenecks and support faster patient triage. This operational value has driven widespread inclusion of troponin into broader acute care testing menus alongside blood gases, CRP, D-dimer, and other time-sensitive diagnostics.

This was not a niche development. The market evolved with a diverse set of players offering POC Tn solutions across different regions and price tiers. Established global companies such as Abbott (i-STAT Tn I), QuidelOrtho (TRIAGE Tn I), Radiometer (AQT90 FLEX Tn I), Roche (cobas h 232 with Roche Cardiac Tn T), Response Biomedical (RAMP Tn I), and PATHFAST (Mitsubishi Chemical Medience) built strong positions in hospital and emergency settings. At the same time, several manufacturers from Asia and other regional players expanded access through compact analyzers and cartridge-based systems designed for cost-sensitive healthcare settings. In many emerging markets, rapid lateral flow troponin tests also gained traction as lower-cost screening options, particularly where infrastructure limitations and reimbursement constraints restricted adoption of more advanced technologies.

However, as emergency departments globally increasingly adopt accelerated and protocol-driven rule-out/rule-in pathways for suspected myocardial infarction (MI), expectations around analytical performance in the ER have shifted. High-sensitivity troponin is now widely positioned in clinical guidelines as the preferred biomarker for MI evaluation, prompting point of care manufacturers to prioritize product development and messaging towards high-sensitivity performance.

The message from the market is becoming increasingly clear: both clinicians and health systems need troponin results that are both fast and highly sensitive to drive critical decisions near patient.

The emerging competitive landscape in POC high-sensitivity Troponin

Several major point-of-care diagnostic players are now active in the point-of-care high-sensitivity troponin space, reflecting an acknowledgement of the growing market need   to bring hsTn closer to the patient. In 2025, Abbott introduced a high-sensitivity troponin-I (hsTnI) cartridge on its widely installed i-STAT system, extending high-sensitivity testing into an established global POC footprint across decentralized and near-lab settings. QuidelOrtho offers the TriageTrue High Sensitivity Troponin I assay on the TRIAGE MeterPro platform in international markets (not available in the US), supported by published evaluations demonstrating strong rule-in/rule-out performance in emergency department settings. PATHFAST (Mitsubishi Chemical Medience) has similarly strengthened its troponin portfolio by positioning its assay with high-sensitivity performance claims on its compact chemiluminescent analyzer. Meanwhile, bioMérieux’s January 2025 acquisition of SpinChip Diagnostics and its hsTnI platform under development signals a continued interest in innovative new players. Roche Diagnostics, already established in central laboratory hsTn and in POC cardiovascular testing (e.g., cobas h 232), is also expected to expand into hsTn offerings with a next-generation platform.

The next phase of the POC hsTn market: Bigger than a single assay launch

Zooming out to look at the broader picture, a few clear themes emerge and go well beyond simply adding another test to a menu.

1. POC is moving up the performance curve
   The conversation is no longer just about speed. The expectation now is fast and analytically robust, with performance that stands up to central lab standards with results that can be correlated to the lab test of record.  The bar has been raised, and POC platforms are being pushed to meet it.
2. Discourse shift from product features to pathway value
   Manufacturers are increasingly being asked tougher, more strategic questions: How do you improve patient flow? What are the economic impacts for health systems and clinical outcomes for patients? Can you support standardized protocols, quality monitoring, and connectivity? The winning argument is no longer just analytical sensitivity, but evidence-backed operational and clinical impact. ER represents a valuable economic driver for hospitals. To free up valuable bed space, the protocol is to diagnose, admit, or discharge patients in a timely manner.
3. Geography will determine who wins and when
   Regulatory pathways, reimbursement environments, and installed base maturity differ significantly across markets, with some platform’s availability uneven across regions and assay rollout timing similarly varied. As a result, adoption curves will be shaped by local realities around competitive intensity, upgrade cycles, and pricing dynamics.
4. Installed base strategy will become critical
   Many health systems already have POC analyzers in place. The next wave of growth will hinge on identifying which accounts are ready for incremental upgrades such as adding new tests, software, or connectivity versus those that require a full system overhaul and replacement. Lifecycle timing, test mix, procurement cycles, and service models will heavily influence commercial success.
5. Connectivity and data integration as the next growth lever
   The value proposition is shifting from standalone devices to how well POC platforms integrate within hospital systems data infrastructure. Enabling seamless data flow, real-time test result visibility, and workflow optimization are now as critical as the test itself.
6. Market Data will separate momentum from market leadership
   As the category matures, anecdotal wins won’t be enough. Share shifts, revenue pools, and adoption rates will need to be quantified. Companies that can see where uptake is accelerating by segment, geography, and account type will move faster and allocate resources more effectively than those operating on assumptions. Ultimately, that’s where market data becomes the real differentiator.

The IQVIA MedTech perspective: Turning momentum into market advantage

Point-of-care hsTn is at an inflection point. But the companies that will win aren't just those with the best assay. They're the ones who understand where the market is forming and how to capture it. The science is accelerating. Product pipelines are maturing. Yet commercial decision-making in POC hsTn remains surprisingly underdisciplined, largely because no one has a true bird's-eye view of the opportunity.

A big part of the challenge lies in how companies think about the installed base. Not every hospital or account is equally ready to adopt. Some can add hsTn to their existing platforms with relatively minor upgrades, while others would need a complete system replacement. Recognizing that difference matters, as it changes the sales approach, the decision timeline, and even the value proposition. Sales funnel management - i.e. where the account is in its equipment lifecycle, how hsTn fits into their current test menu, and when procurement cycles open, all play a role. Treating all accounts as equal leads to wasted effort and missed opportunities.

An even more important element is how this POC solution fits into evolving clinical workflows, where lab-based stat hsTn turnaround times for emergency cases have improved significantly. The key question is whether a new POC hsTn platform delivers enough incremental value over an already fast central lab. If current lab TATs are approaching clinical decision thresholds, hospitals will evaluate whether POC can go a step further by enabling earlier rule-out, improving patient flow, or accelerating triage decisions. Adoption will ultimately depend on whether POC creates a clear, measurable advantage rather than simply matching the performance of existing lab-based testing.

The real risk isn't adoption. It's entering without a thesis.

The market will adopt POC hsTn. The question is who captures the momentum, pricing power, and share when it does. That requires:

• Structured revenue pool mapping - where is demand forming, by geography, care setting, and account type?
• Upgrade-readiness scoring - which accounts are genuinely ready to move, based on lifecycle, menu, and procurement timing?
• Competitive monitoring - where are early share shifts emerging, and what channel strategies (direct, distributor, bundled acute care contracts) reflect local realities?
• Clinical workflow intelligence - how is hsTnI being integrated into actual ER decision pathways, not just ordered?

Anecdotal insight won't get you there. Disciplined, data-driven commercial strategy will.

At IQVIA MedTech, we help bring clarity to this evolving landscape. If you are evaluating market entry, prioritizing countries, assessing competitive dynamics, or refining your commercial strategy in IVD and point-of-care diagnostics, our team can provide data-driven insights tailored to your objectives.