Researchers study heart muscle damage test to better predict intensive care patient outcomes

Heart attack

Cardiac experts in Southampton are investigating whether a blood test that is used to diagnose heart muscle damage can help doctors predict the long-term health outcomes of intensive care patients and ensure they get the most appropriate treatment.

Testing for troponin

The test, which is known as a troponin test, measures levels of the protein ‘troponin’ in the blood. Normally troponin is present in blood in very small quantities but when there is damage to the heart muscle, such as during heart attack, it is released into the bloodstream causing levels to rise.

A troponin test is used alongside an electrocardiogram (ECG) to help doctors determine if an individual has suffered a heart attack. However, raised troponin isn’t always the result of an attack and can be a sign of other forms of heart injury.

“Sometimes a patient may have raised troponin levels when they haven’t suffered a heart attack. This occurs more often when patients are very unwell, such as in intensive care,” explained Professor Nick Curzen who is a consultant cardiologist based at University Hospital Southampton NHS Foundation Trust and is leading the study.

“In these cases clinicians don’t always know the cause of high troponin and, sometimes, patients can end up being inappropriately investigated and treated for a heart attack. Whilst these treatments are of proven benefit in heart attack patients they could potentially be harmful outside this context.

“This is especially relevant in intensive care because patients are often unable to communicate or dismiss other symptoms, like chest pain.”

Improving patient outcomes

The study will analyse the routine blood tests and troponin levels of all patients admitted to intensive care at Southampton General Hospital between X and Y with the aim of identifying what levels are considered ‘normal’ in this patient population.

“We hope to spot patterns and, ultimately, come up with a guide as to what troponin levels can be expected in the intensive care environment, especially when a person hasn’t suffered a heart attack.

“We will then be able to see whether high troponin levels in the absence of an attack can help predict long-term health outcomes. For example, will a patient deteriorate in twelve months time due to higher levels?”

Currently there is no standard treatment plan or strategy for patients with a raised result who haven’t suffered a heart attack.

If this study demonstrates that a high troponin result is linked to worse outcomes later on, further studies could be carried out to see whether certain existing medical therapies, such as commonly used cardiac treatments, could help these patients.

Opting out

Any patient admitted to intensive care at Southampton General Hospital between X and Y, who has a blood test, will be automatically included in this study.

For more information, or if you wish to withdraw your data from this study, please contact the coronary research group via:

Telephone: 023 8120 8538

Email: zoe.nicholas@uhs.nhs.uk or jonathan.hinton@uhs.nhs.uk.

Post: Coronary research group, Cardiovascular and thoracic unit, Southampton General Hospital, Tremona Road, Southampton SO16 6YD

Who has reviewed this study: The East of Scotland Research Ethics Service REC 2, which has responsibility for scrutinising all proposals for medical research on humans, has examined the proposal and raised no objections from the point of view of research ethics. It is a requirement that records in the research, together with any relevant medical records, be made available for scrutiny by monitors from University Hospital Southampton NHS Foundation Trust, whose role is to check that research is properly conducted and the interests of those taking part are adequately protected.

Posted on Monday 7 January 2019