Researchers in Manchester have developed what they claim is a new approach to diagnosing heart attacks in patients admitted to emergency departments.
The “Manchester acute coronary syndromes decision rule” could safely reduce unnecessary hospital admissions, allowing more time and resources to be allocated to patients who need it most, according to the researchers.
Clinicians currently use blood tests to detect heart attacks with the most widely applied test detecting a protein called troponin.
However it can take several hours for troponin levels to rise in the blood after a heart attack, meaning patients are often admitted to hospital to wait for later tests. With chest pain the most common reason for emergency hospital admission, many of these tests subsequently show normal results.
The new decision rule, developed by researchers from Central Manchester University Hospitals Foundation Trust, Stockport Foundation Trust, the University of Manchester and Manchester Metropolitan University, combines the troponin test with levels of another protein, the patient’s symptoms and electrocardiogram findings. Doctors can then determine the chance patients are having a heart attack using a computer programme.
In a study no patients who were identified by the decision rule as being safe to discharge had a heart attack, and over 95 per cent in the “high risk” category had a heart problem.
According to the researchers this could mean that more than one in four patients with chest pain could be safely and immediately discharged from emergency departments.
Dr Rick Body, consultant in emergency medicine at Manchester Royal Infirmary, who led the study, said the study had the potential to make a “huge difference” to the diagnosis and treatment of patients with heart attacks.
Information provided to HSJ