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Test identifies which chest pains are at low risk of heart attack

By: University of Queensland
21 November, 2017

Researchers have shown a single blood test could identify which patients reporting to hospital with chest pain were at low risk of imminent heart attacks.

The University of Queensland was part of an international collaboration which showed the test could more rapidly rule out acute coronary syndrome, reducing patient anxiety and time spent in hospital.

Associate Professor Louise Cullen said researchers evaluated high-sensitivity cardiac troponin I testing, which detects a protein caused by heart damage, to assess coronary risk for people with chest pain.

"We found a single test would determine that almost half of patients reporting with cardiac symptoms were at low risk of heart attack or angina," Dr Cullen said.

"These findings are significant given that chest pain is one of the most common reasons people around the world present to hospitals.

"One of the biggest challenges in emergency settings is the time and resources it takes to work out which patients aren't at significant risk, which can require a raft of tests including ECGs and exercise tests, and admission for observation.

"Only then can we give patients the reassurance that their symptoms are not a heart attack, and look at other causes which might be as benign as reflux or as sinister as something like a clot on the lung."

The report used data from 19 studies involving patients with chest pain to investigate the concentrations of the protein present, and whether they experienced heart attacks within 30 days.

Dr Cullen said the findings of the high-sensitivity test suggested it was a safe way of triaging patients with chest pains.

"Less than point-zero-five per cent of patients identified as at low risk went on to have a heart attack within 30 days," Dr Cullen said.

"This result is in line with current risk assessment procedures."

The test has been available in Australia for two years, and its use in risk assessment is subject to further clinical studies overseas.

Dr Cullen said health authorities had embraced novel assessment strategies for chest pain evaluation and would take into account the results of this new research, and of further clinical studies, before adapting existing protocols for assessing patients with chest pain.

The study is published in JAMA Network.

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