A new blood test can help doctors more quickly determine whether patients arriving in the emergency room with chest pain are having a heart attack, a US study has confirmed.
According to new research published in the American Heart Association’s journal Circulation, initial high-sensitivity test ruled out a heart attack in 30 percent of patients. The second, done at the one-hour mark, put another 25 percent in the clear.
Overall, the study found, that by the three-hour point, the high-sensitivity test had ruled out a heart attack in 84 percent of patients — versus 80 percent with the conventional test.
“We did not miss any heart attacks using this test in this population,” said lead author Rebecca Vigen, MD, MSCS, a cardiologist at the University of Texas Southwestern Medical Center, adding, “The test also allowed us to determine faster that many patients who had symptoms of a heart attack were not having a heart attack than if we had relied on the traditional test.”
The other patients had abnormal troponin results and received further evaluation. In the end, 2 percent were diagnosed with a heart attack, while others had heart-muscle damage from other causes.
The high-sensitivity test did not miss any heart attacks, Vigen said.
The test can help speed a heart attack diagnosis. But the biggest advantage, according to Dr Christopher Granger, a cardiologist at Duke University in Durham, NC, is that it more quickly rules out a heart attack in the many patients who are not having one. Grangeralso serves on the American College of Cardiology/American Heart Association guideline committee for heart attack care.
“And that’s important to patients and their families,” he said.
One hope, Granger noted, is that the quicker test will encourage people with possible heart attack symptoms to call 911 and get help immediately. As it stands, people often dismiss symptoms because they don’t want to go the ER.
With Agencies Inputs
Suicide can’t be predicted by asking about suicidal thoughts : Study
Most people who died of suicide deny they experience suicidal thoughts when asked by doctors in the weeks and months leading up to their death, a major Australian study has found.
The findings, co-authored by clinical psychiatrist and Professor Matthew Large from UNSW’s School of Psychiatry, Sydney that published in the journal BJPsych Open The meta-analysis challenge the widely-held assumption that psychiatrists can predict who will suicide by asking if they are preoccupied with thoughts of killing themselves.
The study showed that 80% of patients who were not undergoing psychiatric treatment and who died of suicide reported not to have suicidal thoughts when asked by their psychiatrist or GP.
“If you meet someone who has suicidal ideation there is a 98 per cent chance that they are not going to suicide,” said Professor Large, an international expert on suicide risk assessment who also works in the emergency department of a major Sydney hospital.
“But what we didn’t know was how frequently people who go on to suicide have denied having suicidal thoughts when asked directly,” he added.
“This study proves we can no longer ration psychiatric care based on the presence of suicidal thoughts alone. We need to provide high-quality, patient-centred care for everyone experiencing mental illness, whether or not they reveal they are experiencing suicidal thoughts,” Professor Large said.
About one in 10 people will have suicidal ideation in their lifetime. But the study showed suicidal ideation alone was not rational grounds for deciding who gets treatment and who does not, Professor Large said.
“We know that suicide feeling is pretty common and that suicide is actually a rare event, even among people with severe mental illness,” Professor Large added.
Suicidal ideation tells us an awful lot about how a person is feeling, their psychological distress, sometimes their diagnosis and their need for treatment but it’s not a meaningful test of future behaviour.
Suicidal feelings can fluctuate rapidly and people may suicide very impulsively after only a short period of suicidal thoughts.
But, people had good reasons not to disclose thoughts of suicide, fearing stigma, triggering over-reactions or upsetting family and friends, and being involuntarily admitted for psychiatric treatment, Professor Large said.
Professor Large emphasized that clinicians should not assume that patients experiencing mental distress without reporting suicidal ideas were not at elevated risk of suicide.