Implementation of rapid rule out of myocardial infarction using high-sensitivity troponin: cross-sectional survey of English hospitals

What is it about?

Recent guidelines recommend using a new blood test, high sensitivity troponin, to quickly rule out a heart attack in people with chest pain and thus reduce the need for hospital admission. We undertook a survey of 131 English hospitals to determine whether they have implemented this guidance.

We received responses from 125 hospitals, with 110 (88%) reporting use of the high sensitivity troponin blood test. In 92 of these (84%) high sensitivity troponin was used to quickly rule out a heart attack, as recommended by the guidance. We received a copy of the hospital guideline from 95 hospitals and 71 (75%) of these advised how to use high sensitivity troponin to quickly rule out a heart attack. Most recommended blood testing on arrival at hospital and three hours later but some recommended shorter time intervals.

Overall, it appears that most English hospitals have implemented the use of high sensitivity troponin to quickly rule out a heart attack, recommending blood sampling on arrival and three hours later.

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