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New system cuts heart attack detection time
A conventional heart attack diagnosis uses any two of these criteria: a positive electrocardiogram (ECG), patient history, and changes in measurements of cardiac markers, including proteins detected in the bloodstream to confirm the onset of a heart attack. The Triage Cardiac System simultaneously measures the levels of three protein markers — myoglobin, cardiospecific tropinin I, and creatinine kinase — in approximately 20 minutes, which is significantly faster than the one to two hours usually required for comparable laboratory work.
A study of this system, conducted at the University of California - San Diego and at the San Diego Veterans Affairs Medical Center, included 1,285 consecutive patients who came to the emergency room with chest pain. The patients were evaluated according to a pathway, which involved frequent serial blood testing with the Triage Cardiac System in order to appropriately triage patients within 90 minutes.
In combination with patient history and ECG changes, physicians using the rapid testing of three cardiac markers diagnosed all cases of myocardial infarction within 90 minutes of arriving in the emergency department with a sensitivity of 100% and specificity of 95%, according to the study. Additionally, use of the algorithm resulted in a 40% decrease in cardiac care unit bed utilization compared to previously used protocols. Of patients with normal ECGs and negative markers at 90 minutes, 90% were discharged.
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