Women are roughly three times more likely to die from coronary heart disease than breast cancer yet about half as many women reporting with chest pain are diagnosed as having had a minor heart attack than men. Newly published research indicates that improved tests for a protein released by the damaged heart muscles and a change in the criteria to assess if there was damage; would identify twice as many women as having had a heart attack. Early intervention is essential in the long term treatment and outcomes for such patients.
Blood tests are necessary because ECG (heart electrical traces) tests can be normal after a minor attack. The tests for increased levels of the protein, troponin, are needed to rule it out or trigger further tests including angiograms.
The study was funded by the charity the British Heart Foundation (BHF) and looked at over 1,000 men and women admitted to the Royal Infirmary, Edinburgh with chest pain during August, September and October 2012. It compared widely used conventional blood tests for troponin with newer, high sensitivity tests and the outcomes in the following year. These included hospital re-admissions and deaths throughout the UK. The results have now been published in the British Medical Journal. While the new test identified a significantly greater number of women, it had little effect on the number of men. The trial will now be extended to over 26,000 patients. Various cost have been quoted in the UK press between £5 and £20 (@US$31) for the test but this is a)the UK cost to buy from the makers, one of which is a US company and b) it is unclear whether this would be a cost additional to the test currently used.
The BHF's Medical Director is quoted on their site as saying:
“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.