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By Martha Kerr
ORLANDO, Mar 19 (Reuters Health) - A test for an enzyme that is more specific than the traditional measurement for heart damage may significantly increase the number of new heart attacks diagnosed each year in this country, cardiologists said here at the annual meeting of the American College of Cardiology.
Traditionally, a heart attack is confirmed when two of the three following conditions are met: symptoms such as chest pain; changes on an electrocardiogram, which takes a measurement of the electrical activity of the heart; and elevated levels of the enzyme CK-MB, which is released by the heart if there is any damage to the organ.
However, in September 2000, the American College of Cardiology and the European Heart Society accepted a new test, cardiac troponin, as an additional criterion in the diagnosis of heart attack.
According to Dr. Mark Meier, a resident physician at the University of Michigan in Ann Arbor, cardiac troponin is a more sensitive marker of heart damage because it is more abundant in heart cells than CK-MB.
Meier participated in a study led by Dr. Rajendra Mehta evaluating the change in adding the new criterion in diagnosing heart attacks.
"These data suggest that under the new criteria, 250,000 more (heart attacks) will be diagnosed each year," he said here at the meeting. "These (heart attacks) would have been missed by the old criteria."
Mehta predicted that the inclusion of cardiac troponin in diagnostic criteria will increase the annual number of heart attacks diagnosed. In the study conducted at their hospital, the investigators considered only intermediate- to high-risk patients, and the new criteria increased heart attack diagnosis by 26%.
"Overall, we expect an increase of 10% to 30%, depending on the level of risk," he told Reuters Health.
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