Date of release: Tuesday 27th January, 2015
An NHS Trust hospital has already successfully adopted a high sensitivity test to help diagnose heart attacks and which was highlighted last week in high-profile research findings.
Royal Wolverhampton NHS Trust, the first in the UK, introduced routine use of the test with gender-specific diagnostic criteria in April 2013 when its new Pathology Lab opened.
Troponins are proteins which increase in the circulation when released from damaged heart muscle during heart attacks.
Because the hsTnI test can reliably measure very low levels of Troponin I, it can be used to rule out heart attacks earlier, easing pressure on waiting lists.
It also has the potential to spot twice as many heart attacks in women because they have lower levels of troponin than men.
Troponin hit the headlines with the publication of research by the Royal Infirmary of Edinburgh.
The British Heart Foundation-funded study, published in the British Medical Journal, reported that using an assay that is more sensitive than standard troponin assays – the ARCHITECT STAT High Sensitive Troponin-I (hsTnI) test manufactured by Abbott - doubled the amount of women diagnosed.
Royal Wolverhampton NHS Trust set up a chest pain pathway almost two years ago using the Abbott ARCHITECT hsTnI test.
They introduced the test at "zero hours" – on arrival of the patient at the hospital - followed by a repeat test at six hours if the patient had not been discharged or already confirmed to have a heart attack (previously a test was only run at 12 hours).
This early testing means potential heart attack patients can be ruled out as having a heart attack or diagnosed and treated much earlier than before. It has made a vast improvement in the way the hospital is able to treat heart attacks and helps lead to much better outcomes for patients.
A clinical evaluation of outcomes over six months revealed that the zero hours test, in tandem with a Clinical Decisions Unit, reduced hospital admissions from 60.9 per cent to 38.4 per cent of patients presenting to the Emergency Department with chest pain.
It is stressed that a single hsTnI test may be used to rule out a heart attack.
"We have been using the high sensitive troponin test to rule out heart attacks earlier in the patient pathway," said Clare Ford, Consultant Clinical Scientist and Head of Clinical Chemistry at the Trust. "It has definitely proved a valuable exercise."
"The introduction of the Abbott ARCHITECT STAT High Sensitive Troponin-I test, in comparison to a standard troponin test, has been a winner, enabling not only more rapid diagnoses and management of heart attacks but also earlier safe discharge from hospital, improving patient flow and easing pressures in hard pressed emergency departments."
"It is good that the findings of the Royal Infirmary of Edinburgh have increased the publicity around gender-specific cut-offs - that is the way forward for the future."
Clare and her colleague Kate Willmer, Consultant Acute Physician, have travelled abroad to lecture on the Trust's use of the Abbott test – most recently to a conference in Dubai.
For further information please contact Clare Ford, Consultant Clinical Scientist on 01902 695286 or Prof. Rousseau Gama in Clinical Chemistry, New Cross Hospital 01902-695285.