Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Tools for diagnosing heart attack could be inaccurate in some populations

02.05.2005


A computerized tool to help emergency room physicians determine whether a patient is having a heart attack may not work as well among some racial and ethnic groups, according to research of almost 12,000 patients at nine medical centers.



"It’s notorious that women and elderly patients have markedly different heart attack symptoms from the younger male patient," said Chadwick D. Miller, M.D., from Wake Forest University School of Medicine. "This study shows us that race and ethnicity also play a role in symptoms."

Results from the research, conducted at Wake Forest and eight other medical centers, are reported in the May issue of Academic Emergency Medicine. The researchers studied a computerized risk stratification tool, called the Acute Coronary Ischemia-Time Insensitive Predictive Instrument (ACI-TIPI), which is designed to predict whether a patient is having a heart attack. Although ACI-TIPI itself is not widely used clinically, its elements form the basis of many other risk assessment tools.


There is no single, definitive test to diagnose heart attacks, making it difficult to evaluate chest pain patients. Risk assessment tools have become popular because they allow doctors to make "evidence-based" decisions based on age, gender, health history, questions about chest pain and an electrocardiogram.

"These tools have mostly been tested in an American, mixed-race population of patients. For example, a typical study population may be comprised of 60 percent Caucasian, 30 percent African-American and 10 percent Hispanic patients," said Miller, an instructor in emergency medicine at Wake Forest’s School of Medicine, which is part of Wake Forest University Baptist Medical Center. "This design does not detect subtle differences that may exist among the groups."

It has been demonstrated that race and ethnicity influence both the perception of chest pain and the time it takes people to seek treatment. Miller said these differences may make the risk assessment tools inaccurate if they are applied to other population groups.

The study compared how well the tool performed in a mixed-race population in the United States versus an Asian population in Singapore.

"What we found was that in Singapore, patients were less likely to exhibit the typical symptom of heart attack: chest pain." Miller said. "Age and male gender also had little predictive power in evaluating whether these patients were having a heart attack."

Miller said the results suggest that doctors should consciously consider the effects of racial or ethnic differences when they use the tools. In addition, they point to the importance of taking ethnic differences into consideration when designing new tools.

"Given the previously demonstrated differences in ethnic groups, combined with our findings, one must question the utility of population-based cardiac risk assessment," said Miller. "We know that typical American patient presents with crushing chest pain. But, this approach doesn’t take into the account the different ethnicities that might present differently."

For the study, the researchers analyzed data from a registry of patients with cardiac symptoms who came to the emergency departments of eight U.S. medical centers and one medical center in Singapore. Any patient who came in with symptoms that might be cardiac – chest pain, shortness of breath, etc. – was included in the study. The researchers looked at the accuracy of ACI-TIPI in predicting acute coronary syndrome (ACS).

ACS is an umbrella term used to cover any group of clinical symptoms compatible with chest pain due to insufficient blood supply to the heart muscle resulting from heart vessel disease. Out of 11,991 patients in the study, 1,120 were diagnosed with ACS.

Other researchers were V. Anantharaman, M.D., from Singapore General Hospital; Christopher Lindsell, Ph.D., and W. Brian Gibler, M.D., from the University of Cincinnati, Charles Pollack, M.S., M.D., and Judd Hollander, M.D., from the University of Pennsylvania, Brian Tiffany, M.D., Ph.D., from Chandler Emergency Medical Group,and James Hoekstra, M.D., and Julie Greenway, B.S., from Wake Forest Baptist.

Karen Richardson | EurekAlert!
Further information:
http://www.wfubmc.edu

More articles from Health and Medicine:

nachricht Usher syndrome: Gene therapy restores hearing and balance
25.09.2017 | Institut Pasteur

nachricht MRI contrast agent locates and distinguishes aggressive from slow-growing breast cancer
25.09.2017 | Case Western Reserve University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: LaserTAB: More efficient and precise contacts thanks to human-robot collaboration

At the productronica trade fair in Munich this November, the Fraunhofer Institute for Laser Technology ILT will be presenting Laser-Based Tape-Automated Bonding, LaserTAB for short. The experts from Aachen will be demonstrating how new battery cells and power electronics can be micro-welded more efficiently and precisely than ever before thanks to new optics and robot support.

Fraunhofer ILT from Aachen relies on a clever combination of robotics and a laser scanner with new optics as well as process monitoring, which it has developed...

Im Focus: The pyrenoid is a carbon-fixing liquid droplet

Plants and algae use the enzyme Rubisco to fix carbon dioxide, removing it from the atmosphere and converting it into biomass. Algae have figured out a way to increase the efficiency of carbon fixation. They gather most of their Rubisco into a ball-shaped microcompartment called the pyrenoid, which they flood with a high local concentration of carbon dioxide. A team of scientists at Princeton University, the Carnegie Institution for Science, Stanford University and the Max Plank Institute of Biochemistry have unravelled the mysteries of how the pyrenoid is assembled. These insights can help to engineer crops that remove more carbon dioxide from the atmosphere while producing more food.

A warming planet

Im Focus: Highly precise wiring in the Cerebral Cortex

Our brains house extremely complex neuronal circuits, whose detailed structures are still largely unknown. This is especially true for the so-called cerebral cortex of mammals, where among other things vision, thoughts or spatial orientation are being computed. Here the rules by which nerve cells are connected to each other are only partly understood. A team of scientists around Moritz Helmstaedter at the Frankfiurt Max Planck Institute for Brain Research and Helene Schmidt (Humboldt University in Berlin) have now discovered a surprisingly precise nerve cell connectivity pattern in the part of the cerebral cortex that is responsible for orienting the individual animal or human in space.

The researchers report online in Nature (Schmidt et al., 2017. Axonal synapse sorting in medial entorhinal cortex, DOI: 10.1038/nature24005) that synapses in...

Im Focus: Tiny lasers from a gallery of whispers

New technique promises tunable laser devices

Whispering gallery mode (WGM) resonators are used to make tiny micro-lasers, sensors, switches, routers and other devices. These tiny structures rely on a...

Im Focus: Ultrafast snapshots of relaxing electrons in solids

Using ultrafast flashes of laser and x-ray radiation, scientists at the Max Planck Institute of Quantum Optics (Garching, Germany) took snapshots of the briefest electron motion inside a solid material to date. The electron motion lasted only 750 billionths of the billionth of a second before it fainted, setting a new record of human capability to capture ultrafast processes inside solids!

When x-rays shine onto solid materials or large molecules, an electron is pushed away from its original place near the nucleus of the atom, leaving a hole...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

“Lasers in Composites Symposium” in Aachen – from Science to Application

19.09.2017 | Event News

I-ESA 2018 – Call for Papers

12.09.2017 | Event News

EMBO at Basel Life, a new conference on current and emerging life science research

06.09.2017 | Event News

 
Latest News

Fraunhofer ISE Pushes World Record for Multicrystalline Silicon Solar Cells to 22.3 Percent

25.09.2017 | Power and Electrical Engineering

Usher syndrome: Gene therapy restores hearing and balance

25.09.2017 | Health and Medicine

An international team of physicists a coherent amplification effect in laser excited dielectrics

25.09.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>