Morges, Switzerland, 2nd June 2011 – Patients presenting symptoms of what appears to be acute coronary syndrome (ACS) account for 5-10% of hospital emergency cases, and up to a quarter of all hospital admissions1. To reduce the risk of an adverse cardiac event, most patients undergo a lengthy medical assessment, but 75-85% of these are not diagnosed with ACS2-4. In order to manage these patients effectively and lessen the burden placed on critical resources, emergency departments and hospitals require a reliable rapid diagnostic test that identifies patients at low risk of a serious cardiac event and enables their early discharge.
A large, multinational study recently published in The Lancet describes a new, two-hour protocol that employs the Alere Triage® CardioProfiler* to assess patients presenting with symptoms of chest pain5. The study was carried out in 14 urban emergency departments across the Asia-Pacific region (ASPECT), and the accelerated diagnostic protocol (ADP) consisted of using a Thrombolysis In Myocardial Infarction (TIMI) pre-test probability score, an electrocardiograph, and results from the Alere Triage® CardioProfiler—a point-of-care panel that measures troponin, creatine kinase MB, myoglobin and BNP—to determine risk for a serious cardiac event.
3,582 consecutive patients, aged 18 years and older and suffering from at least five minutes of chest pain, were recruited for the study and completed a 30-day follow-up. The ADP, made possible by the receipt of accurate cardiovascular biomarker results within 20 minutes, classified 352 (9.8%) patients as low-risk and suitable for early discharge. Of these patients, three (0.9%) experienced a major cardiac event, giving the ADP a sensitivity of 99.3% and a negative predictive value of 99.1%.
Previous rapid protocols have been developed for chest-pain presenters, but these involve a patient assessment that lasts for at least six hours after the onset of symptoms6,7. This new two-hour protocol could significantly reduce the burden on emergency departments and hospital resources, allowing earlier discharge for the majority of patients. According to the study’s authors, “Patients could potentially be discharged several hours earlier to outpatient follow-up and further investigations than with present practices. The implication of more effective and rapid diagnosis of acute chest pain symptoms means a reduction in overcrowding in hospitals and emergency departments and earlier reassurance and greater convenience for patients.”
The Alere Triage® CardioProfiler is available in select markets throughout the world and enables physicians to obtain accurate measurements of the cardiac biomarkers described in the Lancet study within 20 minutes. As evidenced by the study, this turnaround time, when integrated into the ADP, potentially allows for the rapid evaluation of chest-pain presenters and the effective discharge of low-risk patients.
*The Alere Triage® CardioProfiler Panel is a fluorescence immunoassay to be used with the Triage Meters for the quantitative determination of creatine kinase MB, myoglobin, troponin I and B-type natriuretic peptide in EDTA, whole blood and plasma specimens. The test is used as an aid in the diagnosis of myocardial infarction (injury), an aid in the diagnosis and assessment of severity of congestive heart failure (also referred to as heart failure), an aid in the risk stratification of patients with heart failure, and an aid in the risk stratification of patients with acute coronary syndromes.
