Worldwide update on rapid troponin test to rule out heart attack

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27 November 2017

Between 60 and 80 percent of patients admitted to hospital with chest pain have not suffered a heart attack. In a news item on 29 October 2015 we reported a study of 4,870 patients admitted to four Scottish hospitals with a suspected heart attack. The researchers found that 99.6% of those who had a  high-sensitivity cardiac troponin (hs-cTnI) concentration that was lower than a defined, specific threshold had not had a heart attack.

In a cooperative international study, researchers combined data from 22,457 patients with chest pain who had had a troponin measurement (either hs-cTnI or hs-cTnT) on arrival at 19 hospitals across Europe, North America and Australasia. Statistical analysis, reported online on 11 November 2017 in the Journal of the American Medical Association, showed that 99.5% of those with hs-cTnI values below the threshold at least two hours after the onset of chest pain had not had a heart attack. The report noted that further research is needed to evaluate the clinical role of this approach to the identification of low-risk patients suitable for immediate discharge.

Dr Andrew Chapman, Research Fellow at the British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh and a lead author said: “We believe the findings of this worldwide study will provide national and international guidelines committees with the evidence they need to recommend the use of troponin testing to rule out heart attacks much earlier in the emergency department”.