Simple laboratory score can help diagnose heart attacks faster

Scientists have developed a simple lab score that is superior to using cardiac troponin alone for the identification of patients at low and high risk for heart attack or death at emergency department presentation.

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Toronto: Scientists have developed a simple laboratory score that can help quickly diagnose patients with heart attack symptoms. 

The score, published in the Canadian Medical Association Journal, can also identify patients at risk of subsequent heart issues after discharge.

"We have developed a simple lab score that is superior to using cardiac troponin alone for the identification of patients at low and high risk for heart attack or death at emergency department presentation," said Peter Kavsak, McMaster University in Canada.

"This lab score may reduce both the number of blood tests and time spent in the emergency department for chest pain patients," said Andrew Worster, also from McMaster University.

Patients with chest pain symptoms require multiple blood tests over several hours before a diagnosis is reached. Previous studies using high-sensitivity cardiac troponin alone to rule out and rule in heart attacks have not consistently demonstrated sufficient safety to use in clinical practice.

Researchers combined common laboratory blood tests available at many hospitals around the world to create a single laboratory score, or clinical chemistry score, to diagnose the heart attack. These blood tests are part of the World Health Organisation's list of essential in vitro diagnostics tests for healthcare facilities with clinical laboratories.

They validated the clinical chemistry score as a predictor of heart attack or death within 30 days using data on 4,245 patients from emergency department studies in the four countries. Within one month of the emergency department visits, 727 heart attacks or death in patients occurred.

A negative (or low-risk) clinical chemistry score at emergency department presentation missed only one of these events compared with up to 25 missed heart attacks, death when using a high-sensitivity cardiac troponin test alone.

A positive (or high-risk) clinical chemistry score also identified about 75 percent of patients at high risk of heart attack or death when positive compared with a low of 40 percent detected when the high-sensitivity cardiac troponin test alone was positive.

The clinical chemistry score worked equally well in men and women. The researchers suggest the score can be useful for standardizing diagnoses and improving safety.