One of the most common reasons patients go to a hospital emergency department is for chest pain, and as with many medical emergencies, fast evaluation of chest pain leading to the most appropriate treatment is vital for the best possible outcome. The use of a sensitive biomarker to rule in or rule out a heart attack (myocardial infarction) could mean that treatment could begin within hours, as well as avoiding unecessary interventions.
Troponin I is a protein found in the muscle, and increased levels of troponin I in heart muscle are already used to diagnose a heart attack, detected using established troponin I assays. A study carried out at the University Heart Center Hamburg, Germany compared these assays with new and much more sensitive versions in people with suspected heart attacks or angina (chest pain), measured on admission and after three and 6 hours.
In the study, published in JAMA, the researchers used the assays on admission and at three and six hours. Both the conventional and the more sensitive troponin I assays were more sensitive than other biomarkers, but the newer assay was the most effective in the few hours after admission.
"The shortcoming of conventional troponin assays with low sensitivity within the first hours after chest pain onset led to the evaluation of various so-called early biomarkers in the diagnosis of MI. In our study, the diagnostic information of the more sensitive assay was superior to all other evaluated biomarkers alone," says Till Keller, M.D., of the University Heart Center Hamburg, Germany.
Rapid treatment of a heart attack can improve outcome and quality of life for the patient, resulting in faster return to work or community pursuits, as well as reducing costs for the healthcare provider. Using troponin I assays within three hours of admission could help physicians to rule out a heart attack, or diagnose an early diagnosis.