October 13, 2015 — The Lancet published results online that show Abbott’s ARCHITECT STAT High Sensitive Troponin-I (hsTnl) test may rule out myocardial infarction (MI) in two-thirds of very-low risk patients, allowing prompt discharge from A&E (Accident and Emergency). The study identified a precise new threshold of troponin of <5 ng/L which, together with other clinical factors, allows doctors to rule out heart attacks in the majority of patients, reducing prolonged waiting for monitoring with additional tests, unnecessary procedures and hospital admissions.
The study was funded by a special project grant from the British Heart Foundation and conducted by researchers at the University of Edinburgh.
Abbott’s high-sensitive test precisely measures very low levels of cardiac troponin, a protein which at increased levels can indicate injury to the heart. The use of the test helped researchers establish the optimal threshold, which resulted in an overall negative predictive value (the probability that a negative test result is a true negative) of 99.6 percent. The percentage was similar for men and women, across age groups and in patients with prior cardiovascular disease.
“The results show the high sensitive test can help doctors determine with an extremely high level of confidence that a patient may be at low risk of myocardial infarction and therefore can be safely discharged from A&E,” said Atul Anand, M.D., one of the study authors from the University of Edinburgh and Edinburgh Royal Infirmary. “This newly identified threshold has the potential to change how we diagnose patients presenting with chest pain. By establishing a troponin threshold that allows the greatest proportion of patients to be safely discharged, we have the potential to improve patient care and prevent unnecessary hospital admissions and procedures.”
In England and Wales, chest pain accounts for approximately 700,000 visits to A&E each year and patients with suspected acute coronary syndrome (ACS) are commonly admitted to hospital in order to rule out MI. Currently doctors who administer high sensitive troponin blood tests at admission, do so again within 12 hours to evaluate whether or not patients are having heart attacks. This study suggests that by using the newly identified troponin testing level, doctors have the potential to double the number of patients who are discharged directly from A&E following a single, baseline troponin test. In addition, this may provide an opportunity to lower costs incurred by healthcare systems overall.
For more information: www.abbottdiagnostics.com