Research
Rapid heart attack tests speed people through emergency care
People can find out if they are having a heart attack far faster using innovative tests, according to research supported by us and presented at the American Heart Association Scientific Sessions conference in New Orleans.
When someone with chest pain attends hospital as an emergency patient, they are given a blood test for troponin – the telltale protein released into the blood when the heart is damaged, which indicates whether they have had a heart attack.
But doctors say that the test result from blood sent to the laboratory is often not available when they first need it to help make decisions for patients, and a result can sometimes take as long as two hours.
Speeds up decisions
A new study, led from Christchurch Hospital in New Zealand in collaboration with researchers we fund at the University of Edinburgh, investigated the performance of a new type of troponin test. Blood is placed directly onto a cartridge, and analysed on the spot, with some models of the test able to reveal if someone has had a heart attack within 15 to 20 minutes.
In the study, people given a rapid test were admitted to a ward or sent home 47 minutes faster, depending on whether it indicated they had experienced a heart attack, researchers found. This shorter stay in the emergency department, which was the average across six hospitals, was seen in comparison to troponin tests in the lab.
The new tests, produced by various technology firms, are already in use within some British hospitals and could help to tackle long waits and overcrowding within the NHS.
Researchers say the tests could potentially also be used in GP surgeries and chest pain clinics, potentially helping to identify people whose heart attacks might otherwise have been missed.
Ease pressure
Nicholas Mills, BHF Professor of Cardiology at the University of Edinburgh and a consultant interventional cardiologist at Edinburgh Royal Infirmary, helped to design the study, conducted in New Zealand.
Professor Mills said: “When people go to the emergency department fearing they have had a heart attack, a blood sample is taken and sent to another part of the hospital for analysis in a lab. By the time the results are available, it is likely the doctor or nurse will have been called away, so there are unfortunate and unintended delays in making decisions for patients.
“The average turnaround for a lab troponin test can be as long as two hours, so tests which can be performed in real-time within minutes are far better for patients, reducing anxiety as they wait for an answer on what is happening to them.
“Crucially, these tests could also ease some of the pressure on overcrowded emergency departments, helping people move through more quickly.”
Telltale protein
Troponin is a protein found in the muscles, including the heart. When the heart is injured or damaged, such as during a heart attack, troponin is released into the blood.
Hospitals used to routinely test people twice for troponin, to measure changing levels of the protein and establish if they had a heart attack. But the process was sped up, moving people through emergency departments an average of three hours faster, thanks to previous research led by the University of Edinburgh. This showed just one troponin test could effectively identify people who were at high risk of having had a heart attack, and also the people at lower risk who could safely be sent home.
This approach was used in the current study, but, to deliver answers to patients even more quickly, researchers investigated the new generation of devices which can analyse troponin levels in the blood on the spot. The study included almost 60,000 people attending an emergency department in New Zealand between February 2023 and January 2025. A faster test was given to 31,392 patients, while the rest had the standard test with blood samples sent to the laboratory.
Shorter emergency stay
Those given a rapid test, compared to the lab-based test, had a 13 per cent shorter stay in the emergency department on average. That meant they were discharged or admitted to a hospital ward an average of 47 minutes faster. The calculation was made after taking into account other factors affecting how long people wait, such as the time of year and time of day.
Researchers tracked all the people in their study for 30 days after they visited the emergency department, finding that the rate of people dying from cardiovascular disease or having a heart attack in that time was similar whether they were given a fast test or the regular test. This suggests a faster test is a safe way to decide if people should be admitted to a ward or discharged, which should not put people at extra risk by missing their heart attacks.
The test involves a drop of blood, from a standard blood test, being placed on a cartridge which is inserted into the device. The level of troponin then appears on the screen, helping a doctor to provide a diagnosis.
Reassurance or treatment
People who have not had a heart attack can be quickly reassured, thanks to a faster test. Those who have had a heart attack can receive earlier treatment with blood-thinners and be admitted directly to a specialist ward for treatment, which may include a procedure to restore the blood supply to the heart. Early treatment reduces the risk of lasting heart damage.
Dr Sonya Babu-Narayan, our clinical director and consultant cardiologist, said: “Every minute matters if you are having a heart attack. And if you aren’t, you will want to be reassured or diagnosed with something different as soon as possible.
“Troponin is the telltale protein which leaks into the bloodstream when the heart is damaged, so measuring it can be crucial for doctors to diagnose or rule out heart attacks.
“But laboratory results can take hours to come back. So, it’s exciting to see that the bedside troponin test used in this study had a faster turnaround – providing results within minutes, and without compromising accuracy and safety.
“Reducing delays in diagnosis is vital for patients, and also important for pressurised emergency departments working to ensure everyone gets the care they need, when they need it.”
