Test accurately rules out heart attacks in the ER

WASHINGTON -- A simple test appears very good at ruling out heart attacks in people who go to emergency rooms with chest pain, a big public health issue and a worry for patients.

A large study in Sweden found that the blood test plus the usual electrocardiogram of the heartbeat were 99 percent accurate at showing which patients could safely be sent home rather than be admitted for observation and more diagnostics.

Of nearly 9,000 patients judged low risk by the blood test and with normal electrocardiograms, only 15 went on to suffer a heart attack in the next month, and not a single one died.

"We believe that with this strategy, 20 to 25 percent of admissions to hospitals for chest pain may be avoided," said Dr. Nadia Bandstein of the Karolinska University Hospital in Stockholm.

She helped lead the study, published in the Journal of the American College of Cardiology and presented yesterday at the cardiology college's annual conference in Washington.

Chest pain sends more than 15 million people to emergency rooms in the United States and Europe each year, and it usually turns out to be due to anxiety, indigestion or other less serious things. Yet doctors don't want to miss one -- about 2 percent of patients having heart attacks are mistakenly sent home.

People may feel reassured by being admitted to a hospital so doctors can keep an eye on them, but that raises the risk of picking up an infection and expensive care they'll have to pay a share of, plus unnecessary tests. The study included nearly 15,000 people who went to the Karolinska University hospital with chest pains over two years.