Test accurately rules out heart attacks in the ER

[Omaha Steve]

Source: AP-Excite

By MARILYNN MARCHIONE

WASHINGTON (AP) - A simple test appears very good at ruling out heart attacks in people who go to emergency rooms with chest pain, a big public health issue and a huge worry for patients.

A large study in Sweden found that the blood test plus the usual electrocardiogram of the heartbeat were 99 percent accurate at showing which patients could safely be sent home rather than be admitted for observation and more diagnostics.

Of nearly 9,000 patients judged low risk by the blood test and with normal electrocardiograms, only 15 went on to suffer a heart attack in the next month, and not a single one died.

"We believe that with this strategy, 20 to 25 percent of admissions to hospitals for chest pain may be avoided," said Dr. Nadia Bandstein of the Karolinska University Hospital in Stockholm.

FULL story at link.


Read more: http://apnews.excite.com/article/20140330/DACS7AE03.html

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In this Saturday, March 29, 2014 photo, people attend the American College of Cardiology's Annual Scientific Session and Expo in Washington. A large study in Sweden found that a blood test plus the usual electrocardiogram of the heartbeat were 99 percent accurate at showing which patients could safely be sent home rather than be admitted for observation and more diagnostics. (AP Photo/Susan Walsh)

[Erich Bloodaxe BSN]

1. That sounds like a fantastic development.

A 3 day admission to a hospital even in a 'low rent' part of the country for heart attack testing can easily run more than 30k. Being to rule out 75-90% of those stays would be an enormous healthcare cost savings and free up more beds for people with other issues.

[Warpy]

4. Well, serial troponins will keep you in the ER for at least eight hours

but do rule in/rule out full blown MIs without an admission. It would be nice to be able to rule them in or out more quickly. ER gurneys are damned uncomfortable.

Those ruled out have appointments with the cardiologist who saw them in the ER for a stress test in the future.

[Erich Bloodaxe BSN]

5. Those stress tests suck.

And I say that from having taken, rather than given.

I don't recall how long I was in the ER, but I think I wound up being admitted fairly quickly for my 3 day stint, which included multiple EKGs, a monitor, the stress test, as well as a an MRI and an ultrasound, as well as a couple of bags of saline IV. And a bloody large bill. Thankfully, I actually had decent insurance at the time.

[mopinko]

2. will save a ton of money. DH went to er with a gallbladder attack,

was there all night, worked up to the max, and the worst part was that they never did ask what it was if it wasnt a heart attack. he went on to have another horrible attack, and was really lucky not to end up with emergency surgery.

top flight university hospital. beaucoup bucks and he left still sick and in danger.
anything that makes this stuff easier is great.

[cyberswede]

3. Huh...the article says the test for troponin isn't available in the US, but...

I'm certain our ER performs the test.

Regardless...if it's accurate and saves $, that's great.

[Erich Bloodaxe BSN]

6. I think they're saying this is a refinement of a similar test.

Troponin levels are run in the US. (From blood pulled in the grey/green topped lithium heparin tube, iirc) They refer to this other troponin test as a 'faster, more accurate' version in the article, I think.

[magical thyme]

7. the Troponin T test in my lab takes 10 minutes

and is sensitive down to 0.03 ug/L (I think that's the unit. can't remember now...).

I wonder how sensitive and fast this one is.

What takes time is that they run them serially, every 6-8 hours...