A clinical trial that we funded from the University of Edinburgh has shown that using a high sensitivity blood test could rule out a heart attack in two thirds of people arriving at A&E with chest pain.
The research, published today in The Lancet, involved over 6,000 people at four Scottish and US hospitals with chest pain. The researchers evaluated the best way to use a blood test to measure troponin, a protein released from the heart during a
heart attack, and found the threshold at which they could rule out a heart attack and safely send people home. Why do we need to know if someone hasn't had a heart attack?
There are around 188,000 heart attacks in the UK each year. But chest
pain, which can have a number of different causes, is thought to be
responsible for around a million visits to UK A&E departments each
The study shows that if a person high sensitivity troponin-I
concentration of less than 5 nanograms per litre, they are at very low
risk of having had a heart attack or having one in the next 30 days.
This means that someone could more safely and reliably be directly discharged from
hospital, with no need to be admitted.
Building on previous research
Earlier this year, the team showed that the same test could
double diagnosis rates of heart attacks in women. They found that using different criteria for a positive test in men and women improved diagnosis rates so one in five women were diagnosed compared with the standard test where just one in ten women were diagnosed.
What does this mean for future hospital treatment?
The results of this study are likely to be used to shape national and international clinical guidelines on the early rule-out of heart attacks. This will impact on how the majority of patients presenting with chest pain are managed in A&E, influencing future healthcare service provision and patient care.
Professor Jeremy Pearson, our Associate Medical Director said:
"A faster, more accurate diagnosis of whether chest pain is caused by a heart attack would be better for patients and save the NHS money.
"We want to ensure no heart attack diagnosis is missed but we equally don’t want to see people go through unnecessary tests and spend extended periods in hospital unless it is essential. No-one wants to be in hospital unless they have to be.
"What's important about this study is that the evidence shows you can quickly and confidently rule out a heart attack without compromising patient safety."
This research has only been possible thanks to your generous support. Please help us to continue funding world-leading research teams like these across the UK.