Saint Luke Society

New Heart Attack Test May Cut Diagnosis Time to 1 Hour

SLS Seminars

A new test may enable doctors to diagnose a heart attack in as little as one hour, which would save time and money and reduce crowding in hospital emergency rooms, researchers claim.

The latest findings suggest that doctors are able to determine whether or not a heart attack had occurred in 77 percent of patients with heart attack symptoms within an hour of arrival by inputting data collected using a new and more sensitive screening technology that detects changes in cardiac troponin in the blood into an algorithm, according to research published in the Archives of Internal Medicine.

Rising troponin levels are an indicator of a heart attack, and current tests can take three to four and even up to six hours before doctors can detect an increase in cardiac troponin levels.

Of the 439 patients who participated in the study, 259 were classified as not having a heart attack, 76 were confirmed as having a heart attack and 101 were placed in an observational zone in an hour or less.

Researchers found that a 30-day survival was nearly 100 percent in those classified as not having a heart attack, 99 percent in those in the observational group and 95 percent in those who had experienced a heart attack in the follow-up period.

Study authors indicated that about 10 percent of all emergency room consultations are for patients with heart attack symptoms, and older tools used to read levels of cardiac troponin can stall heart attack diagnosis for as long as six hours and lead to overcrowding in emergency rooms.

Researchers said that the algorithm used in the recent study significantly shortened the time needed for rule-out and rule-in of heart attack and may remove the need for “prolonged monitoring and serial blood sampling in three of four consecutive patients with acute chest pain,” the authors concluded.

“There’s a bit more work to be done to show, that in a prospective fashion, by employing these algorithms you have good clinical results,” author of an accompanying editorial professor Kristin Newby, of Duke University Medical Center in Durham, North Carolina, told Bloomberg Businessweek. “This kind of work sets the stage for that and ultimately helps move things forward.”
The more-sensitive blood screening tests are currently unavailable in the U.S., and results from the current observational study should be confirmed “prospectively for clinical decision making,” researchers wrote.

However, if these findings are confirmed in larger more comprehensive testing, algorithms used in the latest study should be integrated into clinical decision support and incorporated into electronic health records or handheld devices to make it easier for healthcare professionals to remember all the information they need, Newby suggested in her accompanying editorial.