Article taken from NZ Herald - 8 June 2017
A New Zealand-developed blood test to identify why some people are suffering chest pains could save $70 million a year and help patients avoid drawn-out hospital stays.
Out of the 50,000 Kiwis seeking medical attention for chest pains each year, only one eighth of those are suffering from a serious heart condition such as a heart attack or unstable angina, said Upstream Medical Technologies chief executive Ruth Appleby.
Then, only two thirds of the people experiencing a serious condition are suffering a heart attack.
Current protocol suggests doctors admit anyone with chest pains to hospital and run tests over several days to rule out life-threatening conditions.
Along with members of the Christchurch Heart Institute, Upstream has developed a test - called UARatio - to rule out angina as a cause of the chest pains, which Appleby said could save New Zealand hospitals up to $70m if used nationally.
"While unstable angina isn't an immediate life-threatening condition, it does correlate with a higher risk of heart attack and there is a desperate, unmet need for clinical biomarkers to assist with clinical decision making," Christchurch Heart Institute associate professor Chris Pemberton said.
"Studies show that patients presenting with angina have a greatly increased risk of suffering a heart attack within six months and morbidity is high. Thus, early intervention is important and the UARatio test is an important step forward in improving the diagnostic process."
The rule-out test identifies the presence of a specific biomarker in the bloodstream and can detect an imminent heart attack before tissue damage occurs. It is currently 98 per cent accurate, Appleby said.
"There's a gold standard blood test to determine if people are having a heart attack, it's as good as that test in terms of accuracy," she said.
The test would be a useful tool to help doctors with their decision-making when it came to treatment.
"A faster diagnosis of unstable angina means that patients do not have to go through days of unnecessary tests," Appleby said.
"This frees up doctors and nursing staff to treat other patients more quickly. Without this test, there is also the threat that a patient could be discharged and miss out on treatment that could help them avoid a heart attack in the future."
Upstream is seeking regulatory approval for the test, which should see it in use in the US near the end of 2019. They could then "piggy-back" off the US approval to have the test brought to New Zealand in 2020.
Appleby said the test was the culmination of about 10 years of research.
She said it was "extremely cool" such a test had been developed in New Zealand.
"This is the same team that discovered what is now used worldwide as the diagnostic for heart failure.
"New Zealand does absolutely world-class research. The ability to harness that and develop a commercial test is the step that we need today. Our ability to get recognised internationally is huge if we can bring this to the market."
Heart Foundation chair of heart health at the University of Auckland Rob Doughty said the potential for the test was "very important and potentially very large due to the large numbers of people who come to hospital with chest pain around the world".
He said the team at the Christchurch Heart Institute had a "long and successful track record of development, evaluation and implementation of novel tests for heart disease".
"As such, the company is very well placed to lead the development of this test."
Unstable angina could be ruled out quickly when someone presented with chest pain, thus avoiding several days in hospital.
Those with the condition could also receive treatment faster.
"Clearly this also has important implications for resource use in the hospital as avoiding hospital admissions will increase the efficiency of the acute hospital services which are increasingly stretched," Doughty said.