Heart attack blood test for earlier discharge

An early rule-out pathway for heart attack has the potential to reduce length of stay and hospital admissions without increasing adverse cardiac events, according to new findings.

The blood test behind the new pathway, presented at the ESC Congress in Paris, is already used by hospitals to diagnose heart attacks and works by measuring the blood levels of a protein, called troponin, released from the heart during a heart attack. Using this pathway, doctors were able to discharge people not suffering from a heart attack quickly and safely.

There are around 188,000 heart attacks in the UK each year. But chest pain, which can have a number of different causes, is thought to be responsible for around a million visits to UK A&E departments each year.

The researchers previously found the threshold at which they could use this test to rule out a heart attack and safely send people with chest pain home. Now, the HiSTORIC trial, funded by the British Heart Foundation, has examined the efficacy and safety of an expedited pathway fro use in hospitals, where high-sensitivity cardiac troponin testing is used to rule out heart attack, compared to standard care.

Jeremy Pearson, Associate Medical Director at the BHF, said: "Each year in the UK, over a million people go to hospital suffering from chest pain. The quicker we can work out whether this chest pain is caused by a heart attack, the quicker we can start treatment.

“This is the first randomised clinical trial to show that a blood test already used in some hospitals to diagnose heart attacks can also be used to safely and effectively rule them out. This is good news for patients, who we can reassure and send home earlier, and it’ll also save hospital resources. Clinical guidelines may well change as a result of this study.”