Novel method for assessment of patients with heart attack symptoms

Myocardial infarction (MI) is more likely if the heart damage biomarker cardiac troponin T (cTnT) is elevated in a blood sample from a patient with chest pain. There is no conventional method to estimate the risk of MI at a specific cTnT concentration. The aim of the study was to develop and evaluate a novel method that converts cTnT concentrations to patient-specific risks of MI.

We analysed admission cTnT measurements in 15,425 patients from three Swedish hospitals with a primary complaint of chest pain, with or without a clinical diagnosis of MI and identified four age and sex-specific subgroups with distinct cTnT distributions.  We further derived a method based on predictive value among lookalikes which calculates the percentage with the disease within a range around the actual patient biomarker concentration to estimate the risk of MI at patient-specific cTnT concentrations with acceptable margins of error. The patient-specific risk of disease using the PALfx could complement decision limits.

This work has been done together with Sahlgrenska Academy, Karolinska University Hospital, and Linköping University.