Heart test could save lives

Analysing blood can identify at risk heart patients

A simple test could help to save the lives of patients with a suspected heart attack, say researchers.

They have found that simultaneous blood testing for three different chemicals can help quickly to identify those most at risk so that they can be given appropriate treatment without delay.

Until now, the individual tests for the three chemicals have rarely been carried out together.

This strategy can help us identify earlier and more effectively high-risk patients who need immediate care, and it may help save lives

Dr Kristin Newby, Duke University Medical Center

By combining the tests and speeding up the analysis process, the researchers, from Duke University Medical Center, North Carolina, were able to identify many more high-risk patients significantly earlier than standard laboratory testing.

Of about 1,000 patients who came into six different emergency rooms complaining of chest pain, the standard laboratory test conducted by the hospitals identified 44 patients at risk, none of whom later died.

But when the combined test was carried out on the same patients, 149 were identified as at risk, of which three soon died.

Many patients who had negative standard tests but positive combination tests later went on to have second heart attacks and such aggressive treatment as angioplasty, a technique to unblock the arteries, or bypass surgery.

Live saver

Researcher Dr Kristin Newby said: "This multi-marker strategy can help us identify earlier and more effectively high-risk patients who need immediate care, and it may help save lives."

Only about 10% of patients who seek emergency care for chest pain show changes consistent with a heart attack on an electrocardiogram - the first diagnostic test physicians use to find evidence of heart trouble.

Many of the rest have only minor problems, but some may be at high risk of dying.

They can be identified by analysing the blood for the presence of chemicals released following damage to the heart muscle.

However, the chemicals are released at different stages following muscle damage, and so carrying out just one test runs a higher risk that the chemical will not be detected.

The combined test used by the Duke researchers increases the chance that the presence of at least one of the chemicals will be picked up.

A British Heart Foundation spokeswoman said: "The speed at which heart attack patients receive treatment is essential so that the damage to their heart can be correctly diagnosed and minimised.

"Improvements in testing using various cell markers of heart damage are being developed all the time and any new approach, such as combining the tests already in use, should be explored to offer the fastest and best possible chance of survival for every heart patient."