New troponin blood test can diagnose heart attack in just one hour

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Thanks to a new algorithm that uses readings from a highly sensitive blood test, doctors may soon be able to diagnose acute heart attack within just one hour of emergency room arrival.

Published in the Archives of Internal Medicine, the latest research on such blood tests focused on finding new methods of application for a particular biomarker: levels of highly-sensitive troponin-T (hs-troponin-T), a protein released into the blood when a heart attack causes cell death. While older tests required that such heart protein and enzyme levels be measured repeatedly for six to 12 hours, researchers from the University Hospital in Basel, Switzerland and a multi-national group of colleagues developed a new algorithm that was able to more accurately diagnose or rule out a heart attack within just one hour.

For the study, a total of 872 emergency room patients with acute chest pain were divided equally into two groups. Blood tests, age, gender, and electrocardiogram results from the first group were used by researchers to develop a new algorithm, which was then validated among the second cohort. This new algorithm allowed researchers to accurately rule out a heart attack in 60 percent of patients, while 17 percent were diagnosed with the condition. Overall, heart attacks were either diagnosed or ruled out in 77 percent of the study participants within one hour.

Given that heart attack symptoms account for 10 percent of emergency room visits and total at least $6 billion in health care costs, it s important for doctors to diagnose the condition more quickly and accurately. But because troponin is also implicated in other maladies, including heart failure, pulmonary embolism, sepsis, and stroke, the authors do caution that their new high sensitivity test may not be ready for widespread use until more studies are completed.

Nevertheless, ACSH's Dr. Gilbert Ross believes the new testing algorithm is a huge advance in medicine. Just the extra time saved is quite valuable, not to mention the extra tests and costs that could be spared. Hopefully, more research will determine that such a test can become a vital part of emergency room standard of care for patients presenting with chest pain.