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December 21, 2023 at 1:44 pm #1530
Anonymous
InactiveNICE UK, has approved two tests for heart attacks, which could help reduce length of hospital stay and lead to earlier access of treatment.
The the tests can be used to rule out heart attacks in people who present to hospitals with chest pain and suspected acute coronary syndrome.
Around 700,000 people are admitted to emergency departments with acute coronary syndrome each year, usually with symptoms of chest pain in UK.
A method of diagnosing whether a heart attack has occurred is to measure the level of the protein called troponin in the blood. This is because troponin is often released into the blood when the heart is damaged due to a heart attack.
In general, tests for troponin are carried out between 10 to 12 hours apart to detect any change in levels. This often means that patients need to remain in hospital while the tests are being carried out.
In latest diagnostics guidance in UK , two new tests are both effective at measuring troponin levels more quickly.
The guidance recommends both the Elecsys troponin T high-sensitive assay and the ARCHITECT STAT high-sensitivity troponin I assay as biomarkers for heart attack.
Both tests are of higher sensitivity than conventional biomarkers and so allow for earlier detection of changes in troponin levels.
This could mean shorter hospital stays for patients with raised levels of troponin, and earlier intervention for those in whom a heart attack has been confirmed.
The guidance adds that as with standard cardiac troponin tests, the new tests need to be used alongside clinical history taking and ECG monitoring to diagnose a heart attack known as a non-ST segment elevation myocardial infarction (NSTEMI).
This is because cardiac troponin levels can also be raised in people who do not have coronary heart disease.
Professor Carole Longson, Director of the Centre for Health Technology Evaluation, said: “Use of these high-sensitivity tests enables the earlier detection of changes in troponin levels.
“This in turn can allow doctors to rule out a diagnosis of a specific type of heart attack called a NSTEMI within as little as 4 hours from the patient being seen in the emergency department.”
“The increased sensitivity of these tests could mean a reduced length of stay for people without raised levels of troponin, and earlier treatment for those with a confirmed NSTEMI,” she added.
Mohan- i would stress the need to take an accurate clinical history, to know the limitations of ECG at presentation( Particularly in NON-ST SEGMENT ELEVATION MYOCARDIAL INFARCTION), monitor for changes in ECG, and of course where available and affordable utilise specific tests like Troponins.
G Mohan.
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