Heart Attack

Successful medical treatment can come down to a precious few minutes, and in an equation where a life may be on the line, anything that saves time helps. 

For patients experiencing symptoms of a heart attack, doctors may soon be able to quickly tell if they are actually having an acute myocardial infarction (MI).

In a new study published in the Canadian Medical Association Journal, Swiss and Spanish researchers tested an algorithm that could determine within an hour whether a patient is indeed having a heart attack.

heart

Of the patients who told emergency room personnel they had a suspected heart attack, just 16 percent actually had a final diagnosis of an acute MI, the medical term for a heart attack. 

The key to the test is cardiac troponins, which are regulatory proteins that are coded by specific genes. Researchers used cardiac troponins as a marker for heart attack.

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“The most surprising, or more correctly reassuring and satisfying, result of the study was that the accuracy of the 1h algorithm was as high as we had hoped for,” said study co-author Dr. Tobias Reichlin of the University Hospital of Basel in Switzerland.

Researchers enrolled 1,714 patients who felt they were having a heart attack and applied a high-sensitive cardiac troponin T 1-hour algorithm to their blood samples. The data were collected from patients at six centers in three countries between 2009 and 2013. Patients had to have experienced the maximum severity of chest pain or the onset of symptoms within the past 12 hours.

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Patients with certain other conditions, such as kidney failure, were excluded from the study. For the remaining 1,320 patients, the test was able to determine the status of 75 percent. 

The participants also had a clinical assessment. Researchers were able to determine that 60 percent of patients did not in fact have a heart attack, 16 percent did, and 24 percent needed to be observed later because the results of the test weren’t conclusive. 

The most surprising, or more correctly reassuring and satisfying, result of the study was that the accuracy of the 1h algorithm was as high as we had hoped for.
Dr. Tobias Reichlin, the University Hospital of Basel

The one-hour algorithm for detecting acute MI allows for a reliable diagnosis in 75 percent of all patients, Reichlin said. For emergency rooms looking to efficiently treat patients, knowing quickly whether a patient is suffering from a heart attack makes a big difference. 

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The test “significantly facilitates and speeds up the assessment of this important patient group in the emergency room and is an important tool to avoid overcrowding in the emergency room,” Reichlin said.

“Based on the additional evidence of the favorable performance demonstrated in this validation study, the 1h algorithm has the potential to change current clinical practice,” he added.

Reichlin said it’s possible the test could be incorporated into the next round of medical guidelines on the management of heart attack patients.