A blood test that could rule out a heart attack in under 20 minutes should be used routinely, say UK researchers.
A
team from King's College London have tested it on patients and say the
cMyC test could be rolled out on the NHS within five years.
They claim it would save the health service millions of pounds each year by freeing up beds and sending well patients home.
About two-thirds of patients with chest pain will not have had a heart attack.
A
heart trace, called an ECG, can quickly show up major heart attacks,
but it is not very good at excluding more common, smaller ones that can
still be life-threatening.
Currently, patients with suspect chest
pain and a clear ECG can have a different heart-attack blood test,
called troponin, when they arrive at A&E. But it needs to be
repeated three hours later to pick up signs of heart muscle damage.
Alison Fullingham, 49 and from Bolton, did not realise she was having
a heart attack when she experienced pain in her upper chest, neck and
jaw.
Despite a small change in her ECG, doctors initially suspected she was having a simple panic attack.
It was only hours later when her troponin tests came back that the correct diagnosis was reached.
Rapid diagnosis
Levels
of cMyC (cardiac myosin-binding protein C) in the blood rise more
rapidly and to a higher extent after a heart attack than troponin
proteins, studies suggest.
That means doctors can use the new
test to rule out a heart attack in a higher proportion of patients
straightaway, according to the researchers who report their trial
findings in the journal
Circulation.
They
carried out troponin and cMyC blood tests on nearly 2,000 people
admitted to hospitals in Switzerland, Italy and Spain with acute chest
pain.
The new test was better at giving patients the all-clear within the first three hours of presenting with chest pain.
Dr
Tom Kaier, one of the lead researchers, funded by the British Heart
Foundation (BHF) at St Thomas' Hospital, London, said: "Our research
shows that the new test has the potential to reassure many thousands
more patients with a single test, improving their experience and freeing
up valuable hospital beds in A&E departments and wards across the
country."
He says if the test were to be used routinely, it could
provide doctors with reliable results within 15 to 30 minutes. It is
only being used for research at the moment, however.
Dr Kaier's
hospital carries out around 7,800 troponin blood tests each year. By his
calculations, switching to cMyC would save his hospital £800,000
through reduced admissions. Extrapolate that to other NHS hospitals and
the savings could be millions of pounds, he says.
Prof Simon Ray,
from the British Cardiovascular Society, said more research was needed
before the new test could replace the troponin test.
"Unlike
currently available blood tests which need to be repeated at least three
hours after pain it looks as though a single test is enough to make a
confident decision on whether a patient has or has not suffered a heart
attack. Not only can it be done earlier after the onset of symptoms but
it also seems to be better at discriminating between heart attacks and
other causes of chest pains. This is very important.
"(BBC-HEALTH)