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 Study tracks inner workings of the brain with new biosensor
16.08.2018 | Rheinische Friedrich-Wilhelms-Universität Bonn

nachricht Foods of the future
15.08.2018 | Georg-August-Universität Göttingen

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: Color effects from transparent 3D-printed nanostructures

New design tool automatically creates nanostructure 3D-print templates for user-given colors
Scientists present work at prestigious SIGGRAPH conference

Most of the objects we see are colored by pigments, but using pigments has disadvantages: such colors can fade, industrial pigments are often toxic, and...

Im Focus: Unraveling the nature of 'whistlers' from space in the lab

A new study sheds light on how ultralow frequency radio waves and plasmas interact

Scientists at the University of California, Los Angeles present new research on a curious cosmic phenomenon known as "whistlers" -- very low frequency packets...

Im Focus: New interactive machine learning tool makes car designs more aerodynamic

Scientists develop first tool to use machine learning methods to compute flow around interactively designable 3D objects. Tool will be presented at this year’s prestigious SIGGRAPH conference.

When engineers or designers want to test the aerodynamic properties of the newly designed shape of a car, airplane, or other object, they would normally model...

Im Focus: Robots as 'pump attendants': TU Graz develops robot-controlled rapid charging system for e-vehicles

Researchers from TU Graz and their industry partners have unveiled a world first: the prototype of a robot-controlled, high-speed combined charging system (CCS) for electric vehicles that enables series charging of cars in various parking positions.

Global demand for electric vehicles is forecast to rise sharply: by 2025, the number of new vehicle registrations is expected to reach 25 million per year....

Im Focus: The “TRiC” to folding actin

Proteins must be folded correctly to fulfill their molecular functions in cells. Molecular assistants called chaperones help proteins exploit their inbuilt folding potential and reach the correct three-dimensional structure. Researchers at the Max Planck Institute of Biochemistry (MPIB) have demonstrated that actin, the most abundant protein in higher developed cells, does not have the inbuilt potential to fold and instead requires special assistance to fold into its active state. The chaperone TRiC uses a previously undescribed mechanism to perform actin folding. The study was recently published in the journal Cell.

Actin is the most abundant protein in highly developed cells and has diverse functions in processes like cell stabilization, cell division and muscle...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

LaserForum 2018 deals with 3D production of components

17.08.2018 | Event News

Within reach of the Universe

08.08.2018 | Event News

A journey through the history of microscopy – new exhibition opens at the MDC

27.07.2018 | Event News

 
Latest News

Smallest transistor worldwide switches current with a single atom in solid electrolyte

17.08.2018 | Physics and Astronomy

Robots as Tools and Partners in Rehabilitation

17.08.2018 | Information Technology

Climate Impact Research in Hannover: Small Plants against Large Waves

17.08.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>