New 8-Minute Blood Test to Diagnose or Rule Out Heart Attack Shortens ED Stay
Posted on 03 Sep 2024
Emergency department overcrowding is a significant global issue that leads to increased mortality and morbidity, with chest pain being one of the most common reasons for hospital admissions. Most patients with chest pain, who are hospitalized for extended periods for evaluation of acute coronary syndrome (ACS), turn out to have non-threatening causes like gastro-esophageal reflux. This makes accelerated diagnostic protocols, including high-sensitivity cardiac troponin (hs-cTn) tests, crucial for the quick assessment and early discharge of patients at low risk. Traditional hs-cTn testing requires two blood samples spaced 1-3 hours apart, each taking about 60 minutes to process. In contrast, point-of-care (POC) testing can yield faster results. Now, late-breaking research presented at ESC Congress 2024 highlights a new rapid blood test that could improve the treatment for individuals presenting with chest pain in emergency departments.
This research was part of the WESTCOR-POC clinical trial conducted at Haukeland University Hospital (Bergen, Norway), where the safety and efficacy of a novel 0-hour and 1-hour POC hs-cTn test were compared against the standard laboratory hs-cTn testing. The POC hs-cTn test, Atellica VTLi from Siemens Healthineers (Forchheim, Germany), demonstrated similar accuracy to lab tests. The study involved 1,494 adult patients showing symptoms of ACS, randomized to either the new eight-minute POC test (728 patients) or the conventional lab test (766 patients). Both groups had comparable demographics and patients were admitted or discharged according to the judgment of the attending physician.
Results showed that the median emergency department stay was slightly reduced by POC testing—174 minutes versus 180 minutes for the standard group. For patients seen by a physician within 60 minutes, POC testing cut emergency department time by 15 minutes (147 vs 162 minutes). POC testing significantly benefited patients with non-ST-elevation myocardial infarction (NSTEMI), reducing their emergency department stay by 43 minutes (137 vs 180 minutes), thus allowing quicker admission to the cardiac ward. Discharge rates within 3 and 6 hours and the total length of hospital stay were similar between the two groups, as were safety outcomes. There were comparable rates of death, heart attacks, and acute revascularizations within 30 days post-discharge (11.4% POC vs 9.4% lab), and very few adverse events occurred after discharge in both groups (0.8% POC vs 0.5% lab), confirming that both testing methods are safe and effective.
“This simple test only requiring a drop of blood can be performed within 8 minutes without the need for a laboratory,” said author Viola Thulin from Haukeland University Hospital. “Use of point-of-care testing on arrival at hospital has the potential to speed up earlier diagnosis or rule out heart attack and reduce the amount of time some patients spend in the emergency department.”
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Haukeland University Hospital
