Heart attack test 'could save many women's lives'
21st January 2015 – Twice as many heart attacks in women could be identified if doctors used a new, more sensitive blood test, a study has concluded.
Research by the University of Edinburgh found that the standard blood test missed many cases in women.
Around 110,000 men and 65,000 women in the UK are diagnosed with a heart attack each year. A woman is nearly three times more likely to die from coronary heart disease than breast cancer, yet often the diagnosis is overlooked.
Looking for troponin
The standard test for detecting heart attacks looks for traces of a protein called troponin which is released from the heart during a heart attack. The researchers compared the effectiveness of this standard test against a high sensitivity test that can detect troponin at much lower levels.
In a study involving 1,126 patients from south east Scotland, the researchers found that almost twice as many men (19%) as women (11%) were diagnosed as having had a heart attack using the standard test.
However, when the more sensitive test was used, the number of women diagnosed with heart attacks doubled from 11% to 22%.
In comparison, only a few extra cases of heart attacks among men were diagnosed using the more sensitive test.
The study, which is published in the BMJ, also found that the extra cases of men and women detected by the more sensitive test involved patients who were at higher risk of dying or having another heart attack in the next 12 months.
Co-author Dr Anoop Shah, clinical lecturer in cardiology at the University of Edinburgh, says in a statement: "While similar numbers of men and women attend the A and E with chest pains, we wanted to know why women are less likely to be diagnosed with a heart attack. At the moment 1 in 10 women with chest pains will be diagnosed with a heart attack compared to 1 in 5 men.
"Our findings suggest one reason for this difference in diagnosis rates of men and women is that we, as doctors, may have been using a threshold for troponin testing that is too high in women."
A further trial is underway to see whether using different thresholds for troponin testing for men women will lead to more accurate diagnoses and save lives.
In a statement, Professor Peter Weissberg, medical director at the British Heart Foundation, which funded the study, says: "We have known for some time that women who have had a heart attack are less likely to be diagnosed than men but we have never had clear evidence as to why that is. But these important results indicate one potential reason.
"This research has shown that the results of the commonly used troponin blood test are significant at different levels in men and women. When the researchers took this into account, they found that twice as many women would be diagnosed with a heart attack.
"If these results are confirmed in the much larger clinical trial we’re funding, these results suggest that using a high sensitivity troponin test, with a threshold specific to each gender, could save many more women’s lives by identifying them earlier to take steps to prevent them dying or having another, bigger heart attack."
High-sensitivity testing is now recommended for assessing heart attack patients by the National Institute for Health and Care Excellence (NICE). In Scotland, the Scottish Intercollegiate Guidelines Network (SIGN) is currently reviewing its guidance on the use of high-sensitivity tests.