Contact Information:

Media Contact

ESC Press office
press@escardio.org

Twitter: escardio

http://www.escardio.org




Kredyty mieszkaniowe Kredyty mieszkaniowe

Sprawdź aktualny ranking najlepszych kredytów mieszkaniowych w Polsce - atrakcyjne kredytowanie nieruchomości.

PRESS-NEWS.org - Press Release Distribution
FREE PRESS RELEASES DISTRIBUTION
RSS - Press News Release
Add Press Release

Rapid, more sensitive test speeds up chest pain triage


2015-08-30
(Press-News.org) LONDON, England - 30 August, 2015: Patients arriving at the emergency department with chest pain suggestive of acute myocardial infarction (AMI) can be triaged more quickly and more safely using a new rapid assay with refined cut-offs, German research suggests.

The Biomarkers in Acute Cardiovascular Care (BACC) study, presented as a Hot Line at ESC Congress 2015, suggests this new algorithm can reduce mortality and cut triage times to one hour, compared to the standard three-hour approach.

"There is an urgent need for fast decision-making for this growing patient population," said principal investigator of the study Dirk Westermann, MD, PhD, from the University Heart Centre Hamburg, and the German Centre for Cardiovascular Research.

"Use of this algorithm in patients with suspected AMI allows for highly accurate and rapid rule-out as well as rule-in, enabling safe discharge or rapid treatment initiation. This rapid algorithm might be applicable to clinical practice without a loss of diagnostic safety."

For patients with suspected AMI, current guidelines recommend analysing cardiac troponin I - a marker of myocyte (cardiac muscle cell) necrosis - directly at admission and then 3 hours later, to determine if the level warrants admission or discharge.

This means patients must remain in the hospital for at least 3 hours before receiving a diagnosis, using resources that are increasingly scarce.

In addition, troponin I levels are currently considered abnormal if they are above the 99th percentile from a healthy reference population - in this case 27 ng/L, said Dr. Westermann.

But new, highly sensitive troponin I assays can give results more quickly and detect more subtle troponin I elevations that may be important for assessing cardiovascular risk, he explained.

The BACC (Biomarkers in Acute Cardiovascular Care) study included 1,045 patients (mean age 65 years) with acute chest pain suggestive of AMI presenting at the emergency room of the university hospital in Eppendorf, Hamburg, Germany.

Patients were assessed using both the standard 3-hour assay as well as a highly-sensitive 1-hour one.

Based on the standard approach, 184 patients were diagnosed with AMI and kept in the hospital, while the rest were discharged home. All patients were then followed for 6 months.

Comparing the results of both assays in the cohort, the researchers calculated the best troponin I cut-off value to rule out AMI was 6 ng/L - "far lower than the currently recommended 27 ng/L," noted Dr. Westermann.

They then tested the clinical relevance of this new cut-off for predicting cardiovascular events using data from the BiomarCaRE study - one of the largest studies to include troponin I measurement in more than 75,000 individuals from the general population.

The BiomarCaRE data confirmed that when individuals from the general population had troponin I values higher than 6 ng/L, they were at increased risk of death or cardiovascular disease, whereas patients with levels below this cut-off could be safely discharged home.

"This documents that even slightly elevated troponin I values are important predictors of cardiovascular disease," said Professor Westermann. "At the same time, utilising a very low cut-off for discharge of patients with suggestive AMI is safe, since these patients are at the lowest possible risk for future events.

The researchers then applied the new cut-offs to the BAAC cohort and found that mortality would have been lower if patients had been triaged with the new algorithm compared to the routine 3-hour approach.

"The standard approach underestimated risk for many patients and resulted in high mortality," said Dr. Westermann. "In addition, using the rapid, sensitive assay would have reduced usage of the emergency room and scarce medical resources, enabling a faster diagnosis and better treatment."

The algorithm had negative predictive values of 99.7% after 1 hour and 100% after 3 hours.

"Therefore, our algorithm identified all patients at risk, but was not un-necessarily unspecific," said Dr. Westermann.

"This suggests that using more sensitive cut-offs than suggested by the guidelines can improve the safety for patients discharged home." The algorithm was then validated in two independent cohorts (ADAPT and APACE trials) that included 4,009 patients with acute chest pain suggestive of AMI.

INFORMATION:


ELSE PRESS RELEASES FROM THIS DATE:

Antimineralocorticoids offer no benefit in heart attack patients without heart failure

2015-08-30
LONDON, UK - 30 August, 2015: Heart attack patients without heart failure derive no benefit from the addition of mineralocortoid receptor antagonists (MRA), to standard therapy, results of the ALBATROSS study show. The Hot Line findings, reported at ESC Congress 2015, "do not warrant the extension of MRA use" to such patients, said the study's principal investigator Gilles Montalescot, MD, PhD. MRAs, also known as aldosterone antagonists, inhibit sodium retention and excretion of potassium and magnesium, and therefore "there is an indication for MRA therapy in MI ...

Peri-infarct pacing does not improve outcomes in patients with large myocardial infarction

2015-08-30
LONDON, UK - In patients with a large myocardical infarction (MI), pacing, with the left ventricular (LV) lead placed in the area of the lesion (peri-infarct) did not prevent further enlargement of the heart (remodeling), nor did it improve functional or clinical outcomes after 18 months, according to results of the Pacing Remodeling Prevention Therapy trial (PRomPT) trial. In MI patients with large infarcts, medical therapy and rapid restoration of blood flow to the area is not always enough to prevent cardiac remodeling. One reason for remodeling may be the response ...

Cyclosporine does not improve outcomes after PCI

2015-08-30
LONDON, UK - 30 August, 2015: The immunosuppressant drug cyclosporine did not improve clinical outcomes compared to placebo in patients receiving percutaneous coronary intervention (PCI) for the more severe form of heart attack known as ST-segment elevation myocardial infarction (STEMI). Results of the CIRCUS trial, presented today in a Hot Line session at ESC Congress 2015, and published simultaneously in the New England Journal of Medicine. showed that the drug, administered prior to PCI, had no impact on a composite of all-cause death, hospitalisation for - or worsening ...

Surprise cardiac finding predicts future risk

2015-08-30
LONDON, UK - In patients with chronic ischemic heart disease, a small left ventricle with thick walls, is the strongest predictor of morphologic remodelling, which is generally considered a first step towards heart failure, according to unexpected findings presented today at ESC Congress 2015. Results of the DOPPLER-CIP (which stands for "Determining Optimal non-invasive Parameters for the Prediction of Left vEntricular morphologic and functional Remodeling in Chronic Ischemic Patients") study were not expected and, if confirmed by other studies, "could completely change ...

How can we prevent suicide? Major study shows risk factors associated with depression

2015-08-30
A major multi-national study of suicides has identified the behaviour patterns which precede many suicide attempts. This may lead to changes in clinical practice in the care of patients affected with depression, as it shows the clinical factors which confer major risk of suicide attempts. The statistics for suicide are frightening. According to the WHO, more than 800,000 people commit suicide every year, with perhaps 20 times that number attempting suicide. Suicide is one of the leading causes of death in the young (in the UK for example, it is the leading cause of death ...

Scientists show how magnetic pulses change the brain in treatment for depressed patients

2015-08-30
A group of UK scientists have found a way of understanding how transcranial magnetic stimulation (TMS) can give relief to severely depressed patients. TMS is used as an alternative to Electro-Convulsive Therapy (ECT)*, but it is not known how it achieves its therapeutic effect. Understanding how it works may open the door to better, more targeted treatment for depression and other conditions. Transcranial magnetic stimulation works by applying a magnetic pulse to the frontal part of the brain of depressed patients. Like ECT, it seems to 'reset' the brain, but is easier ...

A single cocaine dose lowers perceptions of sadness and anger

2015-08-30
A single dose of cocaine can interfere with the ability to recognise negative emotions, according to new research presented at the ECNP conference in Amsterdam. In a placebo-controlled within subject study, researchers from the Netherlands and Germany took 24 students (aged 19 to 27) with light to moderate cocaine use, and gave them either 300mg of oral cocaine, or a placebo. After 1 to 2 hours, each participant was then subject to a series of biochemical tests, as well as the facial emotion recognition test to measure response to a series of basic emotions, such ...

Depression and extremes of blood pressure predict highest rates of harmful vascular events

2015-08-29
London, UK - 29 Aug 2015: Depressive symptoms and extremes of blood pressure predict the highest rates of harmful vascular events in patients with existing heart disease, diabetes or stroke, according to research presented at ESC Congress today by Dr Bhautesh Jani, clinical academic fellow in the Institute of Health and Wellbeing, University of Glasgow, UK.1 The study in more than 35 000 patients found that the risk of further stroke or heart attack, heart failure or dying due to heart disease at four years was 83% higher in depressed patients with high blood pressure ...

Prolonged television watchers have higher risk of fatal pulmonary embolism

2015-08-29
London, UK - 29 Aug 2015: Prolonged television watchers have a higher risk of fatal pulmonary embolism, a condition associated with long haul flights, reveals research presented at ESC Congress today by Mr Toru Shirakawa, public health research fellow in the Department of Social Medicine at Osaka University in Japan.1 The 18 year study in more than 86 000 people found that watching an average of five or more hours of television per day was associated with twice the risk of fatal pulmonary embolism as watching less than two and a half hours daily. "The association between ...

Midday naps associated with reduced blood pressure and fewer medications

2015-08-29
London, UK - 29 Aug 2015: Midday naps are associated with reduced blood pressure levels and prescription of fewer antihypertensive medications, according to research presented at ESC Congress today by Dr Manolis Kallistratos, a cardiologist at Asklepieion Voula General Hospital in Athens, Greece.1 "Although William Blake affirms that it is better to think in the morning, act at noon, eat in the evening and sleep at night, noon sleep seems to have beneficial effects," said Dr Kallistratos. "Two influential UK Prime Ministers were supporters of the midday nap. Winston Churchill ...

LAST 30 PRESS RELEASES:

How your brain decides blame and punishment -- and how it can be changed

Uniquely human brain region enables punishment decisions

Pinpointing punishment

Chapman University publishes research on attractiveness and mating

E-cigarettes: Special issue from Nicotine & Tobacco Research

Placental problems in early pregnancy associated with 5-fold increased risk of OB & fetal disorders

UT study: Invasive brood parasites a threat to native bird species

Criminals acquire guns through social connections

Restoring ocean health

Report: Cancer remains leading cause of death in US Hispanics

Twin study suggests genetic factors contribute to insomnia in adults

To be fragrant or not: Why do some male hairstreak butterflies lack scent organs?

International team discovers natural defense against HIV

Bolivian biodiversity observatory takes its first steps

Choice of college major influences lifetime earnings more than simply getting a degree

Dominant strain of drug-resistant MRSA decreases in hospitals, but persists in community

Synthetic biology needs robust safety mechanisms before real world application

US defense agencies increase investment in federal synthetic biology research

Robots help to map England's only deep-water Marine Conservation Zone

Mayo researchers identify protein -- may predict who will respond to PD-1 immunotherapy for melanoma

How much water do US fracking operations really use?

New approach to mammograms could improve reliability

The influence of citizen science grows despite some resistance

Unlocking secrets of how fossils form

What happens on the molecular level when smog gets into the lungs?

Using ultrasound to clean medical instruments

Platinum and iron oxide working together get the job done

Tiny silica particles could be used to repair damaged teeth, research shows

A quantum lab for everyone

No way? Charity's logo may influence perception of food in package

[Press-News.org] Rapid, more sensitive test speeds up chest pain triage
Press-News.org is a service of DragonFly Company. All Rights Reserved.
Issuers of news releases are solely responsible for the accuracy of their content.