Test rules out heart attacks in two-thirds suffering chest pains
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Version 0 of 1. A simple blood test could rule out a heart attack in two-thirds of people arriving at A&E with chest pains, potentially saving the NHS millions of pounds, a new study shows. There are around 18,000 heart attacks each year in the UK, but around one million people come to A&E with chest pains. The test measures troponin, a protein released from the heart during a heart attack. A low concentration of troponin indicates that this is not a heart attack, which means the patient does not need emergency admission, tests and interventions – and could potentially be cared for at home. “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,” said Professor Jeremy Pearson, associate medical director at the British Heart Foundation, which funded the study published in the Lancet medical journal. “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.” The highly sensitive test could double the numbers discharged home from A&E, say the authors of the study. Lead author Dr Anoop Shah, from the University of Edinburgh, said they had worked out the level of troponin below which the risk of heart attack is very low in the next 30 days. “Over the last two decades the number of hospital admissions due to chest pain has tripled,” said Shah. “The overwhelming majority of these patients do not have a heart attack. “This study shows that low plasma cardiac troponin concentrations at presentation identify up to two-thirds of patients who are at very low risk of heart attack and could be safely discharged from the Emergency Department. Use of this approach is likely to have major benefits for both patients and healthcare providers.” The findings, he added, “could dramatically reduce unnecessary hospital admissions and provide substantial cost savings for healthcare providers”. The authors are now working on a further paper looking at the cost-effectiveness of the test, but believe it could save millions of pounds for the NHS by preventing up to 400,000 admissions a year. |