Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Blood test helps predict heart attack risk for patients with chest pain

31.03.2014

Negative test of sensitive marker may help guide admissions decisions by emergency room

Patients presenting to the emergency department with an undetectable level of the blood biomarker high-sensitivity cardiac troponin T, and whose ECGs show no sign of restricted blood flow, have a minimal risk of heart attack within 30 days, according to research presented at the American College of Cardiology's 63rd Annual Scientific Session.

In a study of all patients (14,636 in total) reporting to a Swedish emergency department with chest pain over a two-year period from 2010 to 2012, researchers examined patients' blood levels of high-sensitivity cardiac troponin T, a marker that indicates damage to the heart.

Nearly 9,000 patients with an undetectable level of the biomarker, or less than 5ng/L, on initial testing, and whose ECGs showed no heart damage from decreased blood flow, were included in the study to examine the primary endpoint of heart attack within 30 days. Researchers found that the negative predictive value of the tests – the probability that patients are not at risk – was 99.8 percent for heart attack and 100 percent for death. This relationship held true regardless of patients' risk factors for heart attack or how long patients had experienced symptoms.

... more about:
»Cardiology »ECG »attack »blood »cardiac »damage »pain

"Chest pain is a potentially life-threatening symptom, as well as being a very common one," said Nadia Bandstein, M.D., Department of Medicine, Karolinska Institute, Solna, Sweden, and the lead investigator of the study. "In our hospital it's the second most common symptom reported in the emergency department. Since there are no established ways to quickly rule out heart attack, many patients are admitted to the hospital unnecessarily, at a large cost to the patient and to society."

According to Bandstein, this is the first large study to specifically examine the use of high-sensitivity cardiac troponin T to predict heart attack risk. The impetus for the study stemmed from the hospital clinicians' observations that patients with undetectable levels of the marker who were admitted to the hospital almost never went on to have heart attacks or need any further work-up, and most went home within a day of admission.

High-sensitivity cardiac troponin T is a relatively new biomarker used in the diagnosis of heart attack and is detectable in the blood several hours before older methods of measuring troponins. Current guidelines recommend that high-sensitivity cardiac troponin T be analyzed at least three hours after the onset of chest pain, which commonly means that patients need to be admitted to the hospital for a second blood test and further evaluation. Bandstein says these study findings suggest that only one measure of the biomarker needs to be taken, and may allow some patients to be discharged directly from the emergency department.

"Despite our observations before the study, we were still surprised by the strength of our findings," Bandstein said. "Using this blood test along with an ECG, we will save about 500 to 1,000 admissions per year in our hospital alone, allowing us to use the beds for sicker patients."

Authors believe this study also has tremendous implications for the 10 million to 15 million patients in the U.S. and Europe who seek emergency treatment for chest pain each year.

During the 30 days of follow-up, 39 of the 8,907 patients were diagnosed with heart attack, and 15 of these patients showed no signs of damage on ECG. What this means, according to researchers, is that only one in 594 patients who seek medical attention for chest pain – but have no signs of heart damage on an ECG and undetectable levels of high-sensitivity cardiac troponin – are actually at immediate risk of heart attack. The average age of patients in the study was 47, and 53 percent were women.

Bandstein recommends that further research be done to assess the risk of heart attack among patients with slightly higher levels of high-sensitivity cardiac troponin T (5-14 ng/L). It will also be important to look at the prognosis for patients diagnosed with heart attack based on slight elevations of the biomarker, she said.

###

This study will be simultaneously published online in the Journal of the American College of Cardiology at the time of presentation.

The ACC's Annual Scientific Session brings together cardiologists and cardiovascular specialists from around the world each year to share the newest discoveries in treatment and prevention. Follow @ACCMediaCenter and #ACC14 for the latest news from the meeting.

The American College of Cardiology is a nonprofit medical society comprised of 47,000 physicians, surgeons, nurses, physician assistants, pharmacists and practice managers. The College is dedicated to transforming cardiovascular care, improving heart health and advancing quality improvement, patient-centered care, payment innovation and professionalism. The ACC also leads the formulation of important cardiovascular health policy, standards and guidelines. It bestows credentials upon cardiovascular specialists, provides professional education, supports and disseminates cardiovascular research, and operates national registries to measure and promote quality care. For more information, visit CardioSource.org

Beth Casteel | EurekAlert!

Further reports about: Cardiology ECG attack blood cardiac damage pain

More articles from Health and Medicine:

nachricht Why might reading make myopic?
18.07.2018 | Universitätsklinikum Tübingen

nachricht Unique brain 'fingerprint' can predict drug effectiveness
11.07.2018 | McGill 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: First evidence on the source of extragalactic particles

For the first time ever, scientists have determined the cosmic origin of highest-energy neutrinos. A research group led by IceCube scientist Elisa Resconi, spokesperson of the Collaborative Research Center SFB1258 at the Technical University of Munich (TUM), provides an important piece of evidence that the particles detected by the IceCube neutrino telescope at the South Pole originate from a galaxy four billion light-years away from Earth.

To rule out other origins with certainty, the team led by neutrino physicist Elisa Resconi from the Technical University of Munich and multi-wavelength...

Im Focus: Magnetic vortices: Two independent magnetic skyrmion phases discovered in a single material

For the first time a team of researchers have discovered two different phases of magnetic skyrmions in a single material. Physicists of the Technical Universities of Munich and Dresden and the University of Cologne can now better study and understand the properties of these magnetic structures, which are important for both basic research and applications.

Whirlpools are an everyday experience in a bath tub: When the water is drained a circular vortex is formed. Typically, such whirls are rather stable. Similar...

Im Focus: Breaking the bond: To take part or not?

Physicists working with Roland Wester at the University of Innsbruck have investigated if and how chemical reactions can be influenced by targeted vibrational excitation of the reactants. They were able to demonstrate that excitation with a laser beam does not affect the efficiency of a chemical exchange reaction and that the excited molecular group acts only as a spectator in the reaction.

A frequently used reaction in organic chemistry is nucleophilic substitution. It plays, for example, an important role in in the synthesis of new chemical...

Im Focus: New 2D Spectroscopy Methods

Optical spectroscopy allows investigating the energy structure and dynamic properties of complex quantum systems. Researchers from the University of Würzburg present two new approaches of coherent two-dimensional spectroscopy.

"Put an excitation into the system and observe how it evolves." According to physicist Professor Tobias Brixner, this is the credo of optical spectroscopy....

Im Focus: Chemical reactions in the light of ultrashort X-ray pulses from free-electron lasers

Ultra-short, high-intensity X-ray flashes open the door to the foundations of chemical reactions. Free-electron lasers generate these kinds of pulses, but there is a catch: the pulses vary in duration and energy. An international research team has now presented a solution: Using a ring of 16 detectors and a circularly polarized laser beam, they can determine both factors with attosecond accuracy.

Free-electron lasers (FELs) generate extremely short and intense X-ray flashes. Researchers can use these flashes to resolve structures with diameters on the...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

Leading experts in Diabetes, Metabolism and Biomedical Engineering discuss Precision Medicine

13.07.2018 | Event News

Conference on Laser Polishing – LaP: Fine Tuning for Surfaces

12.07.2018 | Event News

11th European Wood-based Panel Symposium 2018: Meeting point for the wood-based materials industry

03.07.2018 | Event News

 
Latest News

NYSCF researchers develop novel bioengineering technique for personalized bone grafts

18.07.2018 | Life Sciences

Machine-learning predicted a superhard and high-energy-density tungsten nitride

18.07.2018 | Materials Sciences

Why might reading make myopic?

18.07.2018 | Health and Medicine

VideoLinks
Science & Research
Overview of more VideoLinks >>>