HiSTORIC moment for heart attack diagnosis
A new study from the Centre for Cardiovascular Science indicates a safe, effective test to rule out heart attack and cut down on hospital staff time
At the 2019 European Society of Cardiology Congress, Professor Nick Mills presented the late breaking British Heart Foundation-funded clinical 'HiSTORIC' trial (High-Sensitivity cardiac Troponin On presentation to Rule out myocardial InfarCtion). Involving over 30,000 patients from seven hospitals across Scotland, this randomised trial aimed to assess the use of a single high-sensitivity troponin test to safely rule out myocardial infarction, or heart attacks.
The trial indicated that this single test can be used safely and effectively to accelerate diagnostic decisions and rule out heart attack early on, when patients first present with symptoms. The test determines if patients need to be admitted for further tests. Use of the high-sensitivity troponin test reduced patient length of stay by more than three hours and increased the proportion of patients discharged from the emergency room, avoiding the need for hospital admission and additional testing.
Discharged patients were then followed up for one year and there was no increase in adverse cardiovascular events or cardiac death.
Implementing an early rule out threshold using high-sensitivity troponin test is safe for patients and allows earlier discharge which could lead to substantial savings for healthcare systems and reduce the need for patients to be admitted to hospital. This could cut down on staff time and beds filled, allowing for more serious patients to be treated.
ESC video of Nick Mills explaining the HiSTORIC Trial
Report of HiSTORIC Trial, as presented at the 2019 ESC Congress, Paris