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Test could be used to ‘rule out heart attack’ much earlier

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A low-cost, rapid blood test that spots whether people are at risk of a heart attack could improve the treatment of people with chest pain at emergency departments, suggests an international study.

The test can accurately rule out the risk of heart attack in almost half of all people arriving at hospital emergency departments with chest pains, according to researchers in Scotland.

“This has major potential to improve the safety and efficiency of healthcare delivery”

Andrew Chapman

Use of the test on arrival at hospital could save millions of patients from undergoing further tests and potentially reduce healthcare costs, the researchers said.

They are calling for guidelines on chest pain to be updated so that the test that measures levels of a protein called troponin – released by damaged heart cells – can be integrated into standard care.

In early studies, the test accurately predicted the risk of heart attack in more than 6,000 patients admitted to hospital in Scotland, noted the study authors.

The latest research, led by Edinburgh University, involved almost 23,000 people at 19 hospitals across Europe, North America and Australasia, who received the test after arriving with chest pains.

The findings pinpointed a threshold level of troponin in the blood, below which patients are unlikely to have had a heart attack and are at very low risk of experiencing one in the next 30 days.

Results from the test, which costs around £5 per patient, can be obtained in as little as 20 minutes, helping to safely rule out a heart attack within an hour of arrival at hospital, said the researchers.

They noted that UK patients with chest pain were already given the troponin test when they arrive in emergency department.

However, they said, under current guidelines for interpreting the results, most patients fell into a high risk category that required them to be admitted to for observation and repeated troponin tests.

The researchers said their findings confirmed that guidelines could be safely revised, enabling the discharge of patients not at risk after the results of the first test.

The research, published today in the Journal of the American Medical Association, is being presented this week at the American Heart Association Scientific Sessions in California.

Dr Andrew Chapman, a British Heart Foundation research fellow at the University of Edinburgh, said the findings provided the evidence needed to “recommend the use of troponin testing to rule out heart attacks much earlier in the emergency department”.

“This has major potential to improve the safety and efficiency of healthcare delivery, at a time of increasing financial pressures on our National Health Service,” he added.

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