A test used by doctors in the emergency room to determine if a person is having a heart attack is now equipped to be more sensitive than ever. In addition to diagnosing heart attacks earlier, the test has been shown to decrease the risk of future heart attacks.
From the Karolinska Institutet, researchers introduce a new, high-sensitivity version of the troponin test, a diagnostic method using blood samples for diagnosing heart attack in emergency room patients with chest pain. The test works by detecting troponin levels, and the new test is ten times as sensitive as past tests; it can detect extremely small amounts of troponin.
Troponin is a protein found in heart muscle cells, called cardiomyocytes. These cells are injured during events like a heart attack, where an adequate amount of blood does not reach the heart, and the cells are starved for oxygen and nutrients. In this scenario, cardiomoycytes release troponin, making the protein a key warning sign that a person is having a heart attack.
A troponin test is administered if a person is complaining of chest pain or discomfort, shortness of breath, dizziness, nausea or vomiting, sweating, and exhaustion. Depending on the severity of symptoms or the result of the troponin test, electrocardiograms (ECGs) are another diagnostic method, as they measure the heart’s electrical activity.
The new study fills a gap in the research area of heart attack diagnostics, investigating the potential of the high-sensitivity troponin test to improve survival and lower the risk of future heart attacks.
Researchers conducted their study with about 88,000 heart attack patients in Sweden. About half of the patients had received the high-sensitivity troponin test, and half had received the conventional troponin test. They found that five percent more heart attacks were being diagnosed when the high-sensitivity troponin test was applied compared to the conventional test.
The new troponin test also appeared to be effective at lowering the risk of new heart attacks. It seems that the high-sensitivity test is helping at-risk patients take preventative action to minimize their risk of future heart disease. Improving diagnosis also means that heart attack patients are receiving care sooner, like coronary angiography and balloon angioplasty.
"The increase we observed in our study was less than expected, which means that the high-sensitivity troponin test has enabled doctors to single out the patients who benefit from such intervention,” explained study leader Dr. Martin Holzmann. “We found no differences in medication between the two groups, so the differences in prognosis with fewer new heart attacks could be attributed to the fact that more coronary angiography and balloon dilation procedures have been performed on the right patients.”
The present study was published in the Journal of the American College of Cardiology.