DUBAI: The Lancet published recently results that show Abbott's ARCHITECT STAT High Sensitive Troponin-I (hsTnl) test may rule out heart attacks to help doctors promptly discharge two thirds of patients with chest pain from A&E (Accident and Emergency).These patients may therefore avoid a prolonged wait for monitoring and additional testing or being admitted to hospital. This study suggests that by using a newly identified level of troponin, a protein which at increased levels can indicate injury to the heart doctors may improve patient care by ruling out heart attacks without repeat testing, thereby reducing unnecessary procedures and hospital admissions.The study was funded by a special project grant from the British Heart Foundation and conducted by researchers at the University of Edinburgh.

"The results show the high sensitive test can help doctors determine with an extremely high level of confidence that a patient may be at low risk of having had a heart attack and therefore can be safely discharged from A&E," said Dr Anoop Shah, one of the study authors from the University of Edinburgh. "By using the identified troponin threshold, there are major benefits to patients and doctors. When a patient is diagnosed as low risk of having had a heart attack, it provides much needed reassurance at a time when the patient is most anxious. By being discharged, patients avoid going into hospital and unnecessarily undergoing serial troponin tests which may often cause further worry."

Potential impact

Dr Waleed Tamimi, Consultant, King Abdulaziz Medical City, National Guard, Riyadh, President Saudi Society For Clinical Chemistry said, "In a recent study that was lead by Paul Jülicher, PhD Director International Health Economics & Outcomes Research Medical Affairs Abbott in collaboration with King Abdulaziz Medical City National Guard, in Riyadh has suggested that (hsTrop I) can reduced the turn-around-time and length of stay in emergency department (ED)." (Unpublished yet)

"Using the software Emergency Department Event simulation (EDES) with an average of 569 patients per day in which 88 (15.5%) had acute chest pain, we were able to calculate the new TAT. This study suggests that through the use of hsTnI and shorter ED protocol time for chest pain patients, King Abdulaziz Medical City could realize the following potential benefits:

An optimized ED utilization through reducing bed capacity by 13% or an equivalent of 7 beds per day. The average ED stay time would be reduced by 87 minutes for all patients or 70 minutes for non-chest pain patients.

The total economic benefit would benefit by 12 million € from saving around 12% compared to the current model scenario.

This study may also suggests that by using a newly identified troponin testing level, physicians may have the potential to double the number of patients who are discharged directly from A&E following a single troponin test at presentation.1 In addition, this may provide an opportunity to lower costs incurred by healthcare systems overall.