Published on : Aug 04, 2014
The launch of a new biomarker test for determining acute coronary syndrome (ACS) - that is reported more sensitive to the condition - could see patients spending less time in emergency before they are diagnosed. However, a report in the leading publication, Medical Journal of Australia, this could also cause needless investigations to be performed on people without ACS.
The biomarker - cardiac troponin l (cTn-l) assay - has been introduced very recently into clinical practice across Australia. The higher sensitivity of the assay has improved the ability to identify lower troponin levels. Troponin is the preferred biomarker in diagnosing acute myocardial infarction (AMI). Consequently, cardiac troponin levels can also be detected among healthy individuals; this new test proves efficient in detecting higher levels in AMI at a much earlier stage as compared to the older assays that are less sensitive.
As part of this study, a team of researchers headed by Dr Thomas Yip, at the Cardiology Department of Barwon Health, studied patients that reported at the emergency department of the Geelong Hospital with suspected ACS. These patients were studied between April 23, 2010 and April 22, 2013. It was on 23 April 2012 that the Geelong Hospital incorporated the cTn-l assay.
The team of researchers measured the rate at which patients were admitted to the emergency department, the time spent here, rates of coronary angiography, rates of invasive treatment, rates of ACS diagnosis, as well as the rate of in-hospital mortality attributable to ACS.
Researchers found that although there was no notable difference in the rate of people being admitted to the hospital or the proportion of patients that were diagnosed with ACS, the median time that patients spend in the emergency department was 11.5% less when the high-sensitivity assay was introduced at the hospital. Time spent in the ED dropped from 3.85 hours to 4.35 hours. Moreover, the proportion of patients that had a coronary angiography rose from 45.2 percent to 53.4 percent.