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New Test May Aid Emergency Departments in Heart Attack Diagnoses

Blood test can provide fast and accurate results in cases of chest pain

New research published in The Lancet has found that the cardiac troponin test can safely and quickly rule out a diagnosis of a heart attack. The test can detect low levels of the protein troponin, which is released from the heart during a heart attack.

The study, funded by the British Heart Foundation, involved testing the troponin levels of more than 6,000 people arriving with chest pain at the emergency departments of four Scottish hospitals.

The probability that patients were not at risk of heart attack or subsequent death from a heart condition after 30 days was evaluated through reference to a range of troponin concentrations. As noted by Medical News Today, scientists found that the new test could detect far lower levels of troponin in the blood than previously possible, and they wanted to know if detecting troponin levels of less than 5 ng/L or less in patients with chest pain would predict that the patient was not at risk of a heart attack. A troponin threshold of less than 5 ng/L identified 61% of patients at very low risk of heart attack, with a negative predictive value of 99.6%, regardless of any prior complaint or condition. A year later, the same patients still had a three-times-lower risk of heart attack and cardiac death than those who had troponin levels of 5 ng/L or higher.

International guidelines recommend that individuals presenting with chest pain should be admitted to the hospital to be tested for very high levels of troponin (above the 99th percentile) to affirm that a heart attack has occurred. To do this, patients must be admitted to the hospital or wait for a long time in the emergency department for repeat testing. Lead authors from the study say that use of the test in routine practice could save patients from spending many hours in the emergency department.

Source: Medical News Today, October 8, 2015; Forbes, October 8, 2015.

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