Researchers have developed a simple laboratory score that is safer and faster when diagnosing patients who visit the emergency department with symptoms of a heart attack.
The findings, published in the CMAJ (Canadian Medical Association Journal), suggest that the score may also identify patients at risk for subsequent heart problems after discharge.
"We have developed a simple laboratory score that is superior to the use of cardiac troponin alone for the identification of patients at low and high risk of heart attack or death in the emergency department," said co-author Peter Kavsak of McMaster University. in Ontario, Canada.
"This lab score can reduce both the number of blood tests and the time spent in the emergency room for pain patients in the chest," says Andrew Worster, professor of varsity.
For the study, the team combined common blood tests in laboratories available in different hospitals around the world to produce a single laboratory score or clinical chemistry score to diagnose a heart attack.
These blood tests are part of the World Health Organization (WHO) list of essential in vitro diagnostic tests for healthcare institutions with clinical laboratories.
The researchers validated the clinical chemistry score as a predictor of heart attacks or deaths within 30 days, using data from 4,245 patients from emergency room examinations in four countries – Canada, Australia, New Zealand and Germany.
Within one month of the visit of the emergency department, 727 heart attacks or deaths occurred in patients.
A negative (or low risk) clinical chemistry score in the emergency department missed only one of these events compared to a maximum of 25 missed heart attacks or deaths when using a highly sensitive cardiac troponin test alone.
A positive (or high-risk) clinical chemistry score also identified approximately 75 percent of patients at high risk of heart attacks or deaths when positive compared to a 40 percent low was detected when the highly sensitive cardiac troponin test alone was positive.
The researchers suggest that the score may be useful for standardizing diagnoses and improving safety.
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