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New methods for faster diagnosis of heart attacks developed
If a heart attack is suspected, a quick diagnosis can save lives. Scientists from the University Heart Center (UZH) at the University Medical Center Hamburg-Eppendorf (UKE) have now developed a new diagnostic procedure that should clarify faster whether acute chest pain is caused by a heart attack or not.
According to the UKE, the new diagnostic method has been tested on more than 1,000 patients and has "reduced the time window until the final diagnosis and initiation of life-saving therapy from three to one hour." This also significantly reduced mortality. The study results were published in the specialist magazine "JAMA Cardiology".
Precise testing procedures required
According to Professor Dr. Stefan Blankenberg, Director of the Clinic for General and Interventional Cardiology at the University Heart Center (UHZ), has to “clarify as quickly as possible in patients with chest pain and suspected heart attack whether further therapeutic measures should be initiated or whether they can be safely discharged home "For this," test methods that are as precise, reliable and easy to use as possible "are required. So far, the guidelines of the German Society of Cardiology for suspected heart attacks are to measure the troponin I values using a blood test immediately after admission of the patient and again after three hours.
Biomarker indicates damage to the heart muscle cells
Troponin I is a biomarker "that provides information about damage to the heart muscle cells," the UKE said. However, those affected "must in any case stay in the hospital for at least three hours until a final diagnosis is made," explains Prof. Blankenberg. According to the expert, troponin I values above 27 ng / L are considered to be increased. An alternative has been developed and tested at the UHZ in recent years to speed up the process. Dr. Dirk Westermann, private lecturer at the UHZ and head of the so-called BACC study ("Biomarkers in Acute Cardiac Care"), emphasizes that this new, highly sensitive troponin I test delivers results much more quickly and also detects much lower troponin I values, " which are likely to play an important role in cardiovascular risk. "
New procedure tested on 1,040 patients
As part of the BACC study, the researchers tested their new diagnostic method on 1,040 patients with an average age of 65 who were treated with acute chest pain and suspected heart attack in the emergency room of the UKE. "Both the conventional Troponin I test with a waiting time of three hours and the new test procedure were carried out," reports the UKE. A heart attack was diagnosed in 184 patients based on the standard procedure and further inpatient treatment was arranged. The remaining patients were discharged home. All patients were followed up over a period of twelve months.
Faster and more reliable diagnosis
According to the UKE, when comparing the results of the two test methods, it became clear that “a limit of just 6 ng / L troponin I, measured on admission and after one hour, enables a heart attack to be ruled out more reliably than the previously recommended 27 ng / L with repeat measurement after three hours. " According to Westermann, "the faster-to-use test and the lower limit values could further increase the certainty that the right patients would be sent home." The new algorithm with the lower limit value was based on the data from two other large studies involving more than 4,000 patients acute chest pain and suspected heart attack were involved, verified and confirmed, reports the UKE. Professor Blankenberg concludes that the findings will affect a future change in the guidelines for the diagnosis of acute myocardial infarction. (fp)