Date Posted: July 24, 2026

Author/s: Jave Lian Maxine P. Villalobos, Angella Prudence D. Baguyo, Aura Adel J. Bueser, Jamaeca Ross P. Duqueza, Jana Victoria P. Estanislao, Kryssyl I. Gonzaga, Mako C. Montellano, Zabdielle Emmanuelle C. Parado, Stephanie Ivy A. Pasion, Arabella Francheska C. Sales, Thricia Tolentino, Sherwin N. Reyes

Acute Myocardial Infarction (AMI) remains a major cause of morbidity and mortality worldwide, necessitating rapid and accurate diagnostic strategies for timely clinical intervention. Cardiac Troponin I (cTnI) is the most specific and sensitive biomarker for myocardial injury and is the current gold standard for AMI diagnosis. However, conventional laboratory-based cTnI assays require sophisticated instrumentation, trained personnel, and longer turnaround times, limiting their application in emergency and resourceconstrained settings. Paper-based microfluidic and point-of-care (POCT) platforms emerged as promising alternatives for a rapid, low-cost, and decentralized cTnI detection. This systematic review critically evaluated recent studies published between 2019-2025 on paper-based microfluidic assays for cTnI detection in AMI categorically based by method of detection, including: Colorimetry, Lateral Flow Assay (LFA), Chemiluminescent Assay, Electrochemical Biosensor, Surface-Enhanced Raman Scattering (SERS)-based platforms, and Sandwich Immunoassay. Such were assessed on key parameters including limit of detection (LoD), sample volume, test duration, device design, portability, and suitability for pointof-care use. Among the reviewed studies, the lowest LoD values were reported by Han et al., (0.2 pg/mL in 2024; 0.84 pg/mL in 2020; 0.92 pg/mL in 2019), Li et al. (0.3 pg/mL), Wang et al. (1.0 pg/mL), Gao et al. (2.94 pg/mL), and Fu et al. (4.6 pg/mL). The smallest sample volumes were observed in Vasantham et al., (2 μL) and Li et al., (2.5 μL). In terms of test duration, Song et al., and Vasantham et al., achieved rapid detection times of ~1 minute, while Poosinuntakul et al., reported a longer duration of 60 minutes. Overall, while no single device is optimal across all parameters, paper-based μPADs show substantial potential for transforming AMI diagnostics. Future research should prioritize large-scale clinical validation, device stability, reproducibility, and mass production feasibility to facilitate real-world implementation.

Keywords: Paper-based microfl uidics, μPAD, cardiac troponin I (cTnI), acute myocardial infarction (AMI), point-of-care testing (POCT)