Almost half of emergency room patients with chest pain don’t need the time-consuming and expensive stress tests and cardiac imaging exams.

A new study from Henry Ford Health System found that a newly FDA-approved blood test and heart health scoring system can evaluate these patients in less than two hours.

Eight to 10 million Americans are evaluated in the ER for possible acute myocardial infarction per year. Previous studies have found that heart attack is ruled out for about 85 percent of those patients.
Emergency physicians have traditionally used a blood test that measures the protein troponin to diagnose heart attacks. A more sensitive troponin test that involves highly-sensitive assays was approved by the FDA in February.

The researchers at Henry Ford evaluated 1,282 patients with chest pain who were evaluated in ERs for possible heart attacks between 2011 and 2013. They tested their blood using the new troponin test and scored them with a heart health evaluation called the Heart Score.

The Heart Score looks at the patient’s heart health history, the results of the ECG done in the ER, their age and risk factors such as smoking, hypertension and diabetes.

Within 30 days of evaluation, 217 patients either had a heart attack or died. The 515 patients who had a low Heart Score and normal troponin blood tests over one hour had a .2 percent chance of heart attack at the 30-day mark.

The researchers concluded that 40 percent of the patients in the study could likely go home safely after the troponin test. That would save time and thousands of dollars for both the patients and the hospitals.

“It’s showing where we are headed in the future,” Dr. James McCord, cardiologist at Henry Ford, said in a statement. “Institutions, including our own, are looking at the data and deciding how to incorporate it into our patient evaluation. There wasn’t even the availability of using it until very recently. We’re behind the rest of the world; now the door’s opening for us to use these novel tests.”

The study was recently published online and will be in the March print issue of the American Heart Association’s Circulation: Cardiovascular Quality and Outcomes. A total of 12 hospitals from around the world participated in the study, including Henry Ford and the University of Maryland.

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