Women are nearly three times as likely to die from coronary heart disease than from breast cancer. Even though the same numbers of men and women attend A&E departments with chest pains, the diagnosis of coronary heart disease is often over-looked in women. According to British Heart Foundation figures, one in 10 women who have chest pains will be diagnosed with a heart attack compared with one in five men.
But recent research commissioned by the British Heart Foundation suggests that a NICE-approved test for heart attacks could detect twice as many heart attacks in women than current standard tests.
One of the standard tests used to identify a heart attack is a blood test that identifies the presence of a protein in the blood called troponin. Troponin is produced by the heart muscle when it has been damaged, for example, in a heart attack.
In September 2015, NICE published guidance that recommended two new, high-sensitivity troponin tests. This was followed, in January 2016, by new research published in the BMJ into the diagnostic thresholds of troponin among men and women.
British Heart Foundation-commissioned research was carried out at the Royal Infirmary of Edinburgh and in the US on 1,126 men and women admitted to hospital with chest pain. Researchers gave the patients two versions of the troponin test – the standard test which is most often used in NHS hospitals and can only detect higher levels of troponin in the blood and one of the new, more sensitive tests.
The results showed that the more sensitive test identified hearts attacks in twice as many women as the standard test while only a handful of extra cases were identified in the men. The researchers also realised that the women and men whose heart attacks were identified using the more sensitive test were at a higher risk of death or having another heart attack in the next 12 months.
The Medical Director at the British Heart Foundation, Professor Peter Weissberg, said: “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, they 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.”
Camilla Wonnacott, a member of the Penningtons Manches clinical negligence team, said: “We act for families where a heart attack has been overlooked and the patient has become seriously ill or has lost their life. A more sensitive troponin test available in all NHS A&E departments may be one way to avoid these tragedies.”