(Press-News.org) WASHINGTON (March 30, 2014) — Patients presenting to the emergency department with an undetectable level of the blood biomarker high-sensitivity cardiac troponin T, and whose ECGs show no sign of restricted blood flow, have a minimal risk of heart attack within 30 days, according to research presented at the American College of Cardiology's 63rd Annual Scientific Session.
In a study of all patients (14,636 in total) reporting to a Swedish emergency department with chest pain over a two-year period from 2010 to 2012, researchers examined patients' blood levels of high-sensitivity cardiac troponin T, a marker that indicates damage to the heart. Nearly 9,000 patients with an undetectable level of the biomarker, or less than 5ng/L, on initial testing, and whose ECGs showed no heart damage from decreased blood flow, were included in the study to examine the primary endpoint of heart attack within 30 days. Researchers found that the negative predictive value of the tests – the probability that patients are not at risk – was 99.8 percent for heart attack and 100 percent for death. This relationship held true regardless of patients' risk factors for heart attack or how long patients had experienced symptoms.
"Chest pain is a potentially life-threatening symptom, as well as being a very common one," said Nadia Bandstein, M.D., Department of Medicine, Karolinska Institute, Solna, Sweden, and the lead investigator of the study. "In our hospital it's the second most common symptom reported in the emergency department. Since there are no established ways to quickly rule out heart attack, many patients are admitted to the hospital unnecessarily, at a large cost to the patient and to society."
According to Bandstein, this is the first large study to specifically examine the use of high-sensitivity cardiac troponin T to predict heart attack risk. The impetus for the study stemmed from the hospital clinicians' observations that patients with undetectable levels of the marker who were admitted to the hospital almost never went on to have heart attacks or need any further work-up, and most went home within a day of admission.
High-sensitivity cardiac troponin T is a relatively new biomarker used in the diagnosis of heart attack and is detectable in the blood several hours before older methods of measuring troponins. Current guidelines recommend that high-sensitivity cardiac troponin T be analyzed at least three hours after the onset of chest pain, which commonly means that patients need to be admitted to the hospital for a second blood test and further evaluation. Bandstein says these study findings suggest that only one measure of the biomarker needs to be taken, and may allow some patients to be discharged directly from the emergency department.
"Despite our observations before the study, we were still surprised by the strength of our findings," Bandstein said. "Using this blood test along with an ECG, we will save about 500 to 1,000 admissions per year in our hospital alone, allowing us to use the beds for sicker patients."
Authors believe this study also has tremendous implications for the 10 million to 15 million patients in the U.S. and Europe who seek emergency treatment for chest pain each year.
During the 30 days of follow-up, 39 of the 8,907 patients were diagnosed with heart attack, and 15 of these patients showed no signs of damage on ECG. What this means, according to researchers, is that only one in 594 patients who seek medical attention for chest pain – but have no signs of heart damage on an ECG and undetectable levels of high-sensitivity cardiac troponin – are actually at immediate risk of heart attack. The average age of patients in the study was 47, and 53 percent were women.
Bandstein recommends that further research be done to assess the risk of heart attack among patients with slightly higher levels of high-sensitivity cardiac troponin T (5-14 ng/L). It will also be important to look at the prognosis for patients diagnosed with heart attack based on slight elevations of the biomarker, she said.
INFORMATION:
This study will be simultaneously published online in the Journal of the American College of Cardiology at the time of presentation.
The ACC's Annual Scientific Session brings together cardiologists and cardiovascular specialists from around the world each year to share the newest discoveries in treatment and prevention. Follow @ACCMediaCenter and #ACC14 for the latest news from the meeting.
The American College of Cardiology is a nonprofit medical society comprised of 47,000 physicians, surgeons, nurses, physician assistants, pharmacists and practice managers. The College is dedicated to transforming cardiovascular care, improving heart health and advancing quality improvement, patient-centered care, payment innovation and professionalism. The ACC also leads the formulation of important cardiovascular health policy, standards and guidelines. It bestows credentials upon cardiovascular specialists, provides professional education, supports and disseminates cardiovascular research, and operates national registries to measure and promote quality care. For more information, visit CardioSource.org.
Blood test helps predict heart attack risk for patients with chest pain
Negative test of sensitive marker may help guide admissions decisions by emergency room
2014-03-31
ELSE PRESS RELEASES FROM THIS DATE:
The Atlantic Ocean dances with the sun and volcanoes
2014-03-31
Imagine a ballroom in which two dancers apparently keep in time to their own individual rhythm. The two partners suddenly find themselves moving to the same rhythm and, after a closer look, it is clear to see which one is leading.
It was an image like this that researchers at Aarhus University were able to see when they compared studies of solar energy release and volcanic activity during the last 450 years, with reconstructions of ocean temperature fluctuations during the same period.
The results actually showed that during the last approximately 250 years – since ...
Researchers reveal a new pathway through the sodium pump
2014-03-31
A study in The Journal of General Physiology provides new evidence that the ubiquitous sodium pump is more complex—and more versatile—than we thought.
The sodium pump is present in the surface membrane of all animal cells, using energy derived from ATP to transport sodium and potassium ions in opposite directions across the cell boundary. By setting up transmembrane gradients of these two ions, the pump plays a vital role in many important processes, including nerve impulses, heartbeats, and muscular contraction.
Now, Rockefeller University researchers Natascia Vedovato ...
Data show benefit of comprehensive lipid testing in determining risk for coronary heart disease
2014-03-31
Washington, D.C., March 31, 2014 ― Data presented from two meta-analyses using the Atherotech Vertical Auto Profile (VAP®) Lipid Panel showed the impact high-density lipoprotein (HDL) cholesterol and remnant lipoprotein (RLP) cholesterol have on determining a patient's risk for hard coronary heart disease (CHD) endpoints, such as myocardial infarction or coronary death. Each analysis examined men and women without prevalent CHD enrolled in both the Framingham Offspring and Jackson Heart studies over eight years. In both studies, HDL, the "good" cholesterol in the ...
Giving steroids during bypass surgery shows no benefit, some harm
2014-03-31
WASHINGTON (March 31, 2014) — Giving patients steroids at the time of heart surgery does not improve health outcomes and appears to put them at greater risk of having a heart attack in the days following surgery, according to research presented at the American College of Cardiology's 63rd Annual Scientific Session. The finding, which stems from the largest randomized trial in cardiac surgery ever conducted, challenges a practice that many surgeons have used for decades.
"Based on these results, we suggest that steroids should not be used prophylactically during cardiac ...
Metformin fails to reduce heart failure after heart attack
2014-03-31
Washington (March 31, 2014) — The use of metformin, a common regulator of blood glucose for diabetics, does not help protect against heart failure in non-diabetic patients who have suffered a heart attack, according to research presented at the American College of Cardiology's 63rd Annual Scientific Session.
The GIPS-III trial is the first double-blind, randomized, placebo-controlled study conducted to evaluate whether four months of metformin treatment preserved left ventricular function in non-diabetic patients with acute myocardial infarction.
Metformin is commonly ...
Bariatric surgery beats medical therapy alone for managing diabetes
2014-03-31
WASHINGTON (March 31, 2014) — Gastric bypass and sleeve gastrectomy – two of the most commonly used bariatric surgeries – are more effective than intensive medical therapy alone when it comes to managing uncontrolled type 2 diabetes in overweight or obese patients after three years, according to research presented at the American College of Cardiology's 63rd Annual Scientific Session.
STAMPEDE is the largest randomized controlled trial with one of the longest follow-ups to compare the effect of these two procedures to intensive medical therapy in helping patients achieve ...
'Ivory tower' bucking social media
2014-03-31
EAST LANSING, Mich. — University scholars are largely resisting the use of social media to circulate their scientific findings and engage their tech-savvy students, a Michigan State University researcher argues in a new paper.
While social media is widely used in fields such as journalism and business – not just to push a product but also to engage in open dialogue with readers and clients – it has failed to take hold in academia's so-called ivory tower. This is troubling given that universities in the United States and Europe are trying to increase access to publicly ...
Can vitamin A turn back the clock on breast cancer?
2014-03-31
(PHILADELPHIA) – A derivative of vitamin A, known as retinoic acid, found abundantly in sweet potato and carrots, helps turn pre-cancer cells back to normal healthy breast cells, according to research published this month in the International Journal of Oncology. The research could help explain why some clinical studies have been unable to see a benefit of vitamin A on cancer: the vitamin doesn't appear to change the course of full-blown cancer, only pre-cancerous cells, and only works at a very narrow dose.
Because cells undergo many changes before they become fully ...
Excessive hospital occupancy levels result in avoidable mortality
2014-03-31
Once a hospital reaches a certain occupancy level, the quality of care it provides deteriorates, increasing the risk of mortality of critically ill patients. What is worrying is that this safety 'tipping point' is reached at occupancy levels that are below 100%. The findings are reported by a team of researchers led by Ludwig Kuntz, Professor of Health Management at the University of Cologne. Their paper (Stress on the Ward: Evidence of Safety Tipping Points in Hospitals) is to appear shortly in the international journal Management Science.
For the purposes of their study, ...
Anesthetic technique important to prevent damage to brain
2014-03-31
Researchers at the University of Adelaide have discovered that a commonly used anesthetic technique to reduce the blood pressure of patients undergoing surgery could increase the risk of starving the brain of oxygen.
Reducing blood pressure is important in a wide range of surgeries – such as sinus, shoulder, back and brain operations – and is especially useful for improving visibility for surgeons, by helping to remove excess blood from the site being operated on.
There are many different techniques used to lower patients' blood pressure for surgery – one of them is ...
LAST 30 PRESS RELEASES:
New model of neuronal circuit provides insight on eye movement
Cooking up a breakthrough: Penn engineers refine lipid nanoparticles for better mRNA therapies
CD Laboratory at Graz University of Technology researches new semiconductor materials
Animal characters can boost young children’s psychological development, study suggests
South Korea completes delivery of ITER vacuum vessel sectors
Global research team develops advanced H5N1 detection kit to tackle avian flu
From food crops to cancer clinics: Lessons in extermination resistance
Scientists develop novel high-fidelity quantum computing gate
Novel detection technology alerts health risks from TNT metabolites
New XR simulator improves pediatric nursing education
New copper metal-organic framework nanozymes enable intelligent food detection
The Lancet: Deeply entrenched racial and geographic health disparities in the USA have increased over the last two decades—as life expectancy gap widens to 20 years
2 MILLION mph galaxy smash-up seen in unprecedented detail
Scientists find a region of the mouse gut tightly regulated by the immune system
How school eligibility influences the spread of infectious diseases: Insights for future outbreaks
UM School of Medicine researchers link snoring to behavioral problems in adolescents without declines in cognition
The Parasaurolophus’ pipes: Modeling the dinosaur’s crest to study its sound #ASA187
St. Jude appoints leading scientist to create groundbreaking Center of Excellence for Structural Cell Biology
Hear this! Transforming health care with speech-to-text technology #ASA187
Exploring the impact of offshore wind on whale deaths #ASA187
Mass General Brigham and BIDMC researchers unveil an AI protein engineer capable of making proteins ‘better, faster, stronger’
Metabolic and bariatric surgery safe and effective for patients with severe obesity
Smarter city planning: MSU researchers use brain activity to predict visits to urban areas
Using the world’s fastest exascale computer, ACM Gordon Bell Prize-winning team presents record-breaking algorithm to advance understanding of chemistry and biology
Jeffrey Hubbell joins NYU Tandon to lead new university-wide health engineering initiative & expand the school’s bioengineering focus
Fewer than 7% of global hotspots for whale-ship collisions have protection measures in place
Oldies but goodies: Study shows why elderly animals offer crucial scientific insights
Math-selective US universities reduce gender gap in STEM fields
Researchers identify previously unknown compound in drinking water
Chloronitramide anion – a newly characterized contaminant prevalent in chloramine treated tap water
[Press-News.org] Blood test helps predict heart attack risk for patients with chest painNegative test of sensitive marker may help guide admissions decisions by emergency room