NICE has recommended two new high-sensitivity troponin tests to help reduce the time it takes assess heart attacks.

The tests – involving Elecsys troponin T high-sensitive assay and ARCHITECT STAT high-sensitivity troponin I assay – measure cardiac troponin levels in the blood of patients with a suspected heart attacks. These tests can detect lower levels of troponin in the blood than previously available tests, meaning a clinical diagnosis can be made much sooner.

Standard cardiac troponin tests are typically carried out 10-12 hours apart so that a change in troponin levels can be detected. For many people, this means that they have to be admitted to hospital for observation while the testing is carried out.

High-sensitivity troponin tests have been developed that are able to detect lower levels of troponin in the blood, and therefore can detect a change in levels of troponin earlier and enable an earlier discharge for patients who have not had a heart attack.

“Use of these high-sensitivity tests enables the earlier detection of changes in troponin levels,” said Professor Carole Longson, NICE Health Technology Evaluation Centre Director. “This in turn can allow doctors to rule out a diagnosis of a specific type of heart attack called a non-ST-segment elevation myocardial infarction (NSTEMI) within as little as 4 hours from the patient being seen in the emergency department.

“The increased sensitivity of these tests could mean a reduced length of stay for people without raised levels of troponin, and earlier treatment for those with a confirmed NSTEMI.”

As with standard cardiac troponin tests, the new tests need to be used alongside clinical history taking and ECG monitoring to diagnose NSTEMI. This is because cardiac troponin levels can also be raised in people who do not have coronary heart disease.

A further high-sensitivity cardiac troponin test - the AccuTnI+3 assay (Beckman Coulter) is recommended for research to gain information on its use for the early rule out of NSTEMI in people presenting to an emergency department with a suspected acute coronary syndrome.