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Strategy May Help ER Docs Spot Heart Attacks Within an Hour
Date:8/13/2012

MONDAY, Aug. 13 (HealthDay News) -- A test based on certain cardiac enzymes could help emergency department staff spot heart attacks in incoming patients within an hour, a new study finds.

The test, called high-sensitivity cardiac troponin (hs-cTn), would be used along with electrocardiography and physical exams to improve the early diagnosis of heart attacks for patients coming to the ER complaining of chest pain, the Swiss researchers said.

As one expert not connected to the study explained, cardiac enzymes called troponins can point to heart attack.

"Cardiac troponins are highly specific for the presence of myocardial cell necrosis (death of heart muscle)," said Dr. Hal Chadow, co-director of the Division of Cardiology at Brookdale University Hospital and Medical Center in New York City. Although troponins are most often elevated in people who have suffered a heart attack, he said, they also can be linked to other conditions such a heart failure, pulmonary embolisms (clots in the lungs) and stroke.

Chadow said accurate, rapid means of confirming heart attacks in the ER are needed.

"Approximately 5.5 million patients are seen in [U.S.] emergency departments annually for chest pain," he said, and "rapid diagnosis and early risk stratification are important goals."

Cardiac troponin measurement may be a key ingredient to this process, he added, since "previous studies have demonstrated very low 30-day event rates in patients with no elevation in cardiac troponin."

The new study was led by Dr. Tobias Reichlin of University Hospital Basel in Switzerland and published Aug. 13 in the journal Archives of Internal Medicine. Reichlin's team tracked nearly 900 patients with severe chest pain who visited the emergency room, including almost 150 for whom heart attack was confirmed as the final diagnosis.

About half of all patients were assessed using the new method.

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