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Researchers in the Netherlands have found that about 30% of emergency department visits by patients with chest pain could be avoided if ambulance crews used a high-sensitivity troponin test alongside other measures during prehospital triage.

At present, about 95% of people with chest pain are transported by ambulance to emergency departments for further evaluation, but only a minority have a serious cardiac condition. The study presented at the European Emergency Medicine Congress is the first to investigate how combining a high-sensitivity point-of-care troponin test with the HEART score affects hospital referrals for these patients.

Troponin tests measure the level of troponin proteins in the blood, which rises when the heart muscle is damaged. Normally, these tests are carried out in a hospital laboratory after patients reach the emergency department.

New high-sensitivity point-of-care troponin tests, such as the QuidelOrtho test used in this study, can provide on-the-spot results, often in less than 20 minutes. They have been shown to be as accurate as tests analyzed in a central laboratory and are starting to be used to make faster decisions about emergency department patients with chest pain.

The HEART score takes into account factors such as a patient's medical history, age, electrocardiogram (ECG) abnormalities and risk factors like smoking. It categorizes patients as being at low, medium or high risk of a heart problem and incorporates a troponin test result.

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