Faster Tests for Heart Attack Diagnosis: Study


People taking the less accurate three-hour test would have to wait longer in the hospital, putting them at risk for disease, according to study by NTUH

  • By Wu Liang-yi / Journalist

An international study conducted by the National Taiwan University Hospital (NTUH) found that one-hour tests to diagnose a myocardial infarction are more accurate than more established algorithms that can take three or more hours.

Lee Chien-chang (李建璋), a professor in NTUH’s emergency medicine department who led the study, shared his findings at a press conference in Taipei on Friday, after it was published in the Annals of Internal Medicine Tuesday.

The 2020 European Society of Cardiology guidelines recommend using the 0/1 hour and 0/2 hour algorithms, rather than the 0/3 hour algorithm, as the first and second choice for high sensitivity strategies based on cardiac troponin for triage of patients with suspected acute myocardial infarction, according to the study.

After analyzing 32 studies from 11 countries involving 30,066 patients, the study assessed the diagnostic accuracy of the three algorithms.

With the 0/3 hour algorithm, which is more widely used in hospitals, people suspected of having had a myocardial infarction must have two cardiac troponin tests, one at the start and one after three hours, Lee said.

This means they have to wait longer in the emergency room, which not only makes the room more crowded, but puts them at a higher risk of contracting diseases such as COVID-19, Lee said.

The team’s study found that, compared to the 0/1 hour and 0/2 hour algorithms, the 0/3 hour algorithm has a lower accuracy rate for myocardial infarction, he said. declared.

Although there is a popular notion in the medical field that different algorithms vary only in their effectiveness, the study found that they are also relevant for patient safety, he added.

With the 0/3 hour algorithm, up to 15 in 1,000 patients with acute myocardial infarction could be mistakenly identified as healthy, while the number drops to three when using the new procedures 0/1 and 0/2 hours, Lee said.

New testing methods were launched a few years ago and their use is covered by national health insurance, so it wouldn’t be difficult to promote their use in more hospitals, he said.

The study is expected to trigger changes in the guidelines followed by emergency rooms and prompt more surgeons to adopt the new procedures, the hospital said.

CNA Supplementary Reports

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