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New Heart Attack Test May Cut Diagnosis Time to 1 Hour

A new test may enable doctors to diagnose a heart attack in as little as one  hour, which would save time and money and reduce crowding in hospital emergency  rooms, researchers claim.

The latest findings suggest that doctors are able to determine whether or not a  heart attack had occurred in 77 percent of patients with heart attack symptoms  within an hour of arrival by inputting data collected using a new and more  sensitive screening technology that detects changes in cardiac troponin in the  blood into an algorithm, according to research  published in the Archives of Internal Medicine.

Rising troponin levels are an indicator of a heart attack, and current tests  can take three to four and even up to six hours before doctors can detect an  increase in cardiac troponin levels.

Of the 439 patients who participated in the study, 259 were classified as not  having a heart attack, 76 were confirmed as having a heart attack and 101 were  placed in an observational zone in an hour or less.

Researchers found that a 30-day survival was nearly 100 percent in those  classified as not having a heart attack, 99 percent in those in the  observational group and 95 percent in those who had experienced a heart attack  in the follow-up period.

Study authors indicated that about 10 percent of all emergency room  consultations are for patients with heart attack symptoms, and older tools used  to read levels of cardiac troponin can stall heart attack diagnosis for as long  as six hours and lead to overcrowding in emergency rooms.

Researchers said that the algorithm used in the recent study significantly  shortened the time needed for rule-out and rule-in of heart attack and may  remove the need for "prolonged monitoring and serial blood sampling in three of  four consecutive patients with acute chest pain," the authors concluded.

"There's a bit more work to be done to show, that in a prospective fashion,  by employing these algorithms you have good clinical results," author of an  accompanying editorial professor Kristin Newby, of Duke University Medical  Center in Durham, North Carolina, told Bloomberg Businessweek. "This  kind of work sets the stage for that and ultimately helps move things  forward."

The more-sensitive blood screening tests are currently unavailable in the  U.S., and results from the current observational study should be confirmed  "prospectively for clinical decision making," researchers wrote.

However, if these findings are confirmed in larger more comprehensive  testing, algorithms used in the latest study should be integrated into clinical  decision support and incorporated into electronic health records or hand held  devices to make it easier for health care professionals to remember all the  information they need, Newby suggested in her accompanying editorial.

Source: Medical Daily at  http://www.medicaldaily.com/articles/11494/20120814/hour-test-heart-attack-emergency-room-diagnosis.htm#Em41fBAFljgTmV7d.99

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