"It is notorious that women and elderly patients have markedly different heart attack symptoms from the younger male patient,” said Chadwick D. Miller, M.D., from Wake Forest University School of Medicine. "This study shows us that race and ethnicity also play a role in symptoms.”
The researchers studied a computerised risk stratification tool, called the Acute Coronary Ischemia-Time Insensitive Predictive Instrument (ACI-TIPI), which is designed to predict whether a patient is having a heart attack. Although ACI-TIPI itself is not widely used clinically, its elements form the basis of many other risk assessment tools.
There is no single, definitive test to diagnose heart attacks, making it difficult to evaluate chest pain patients. Risk assessment tools have become popular because they allow doctors to make evidence-based decisions based on age, gender, health history, questions about chest pain and an electrocardiogram.
It has been demonstrated that race and ethnicity influence both the perception of chest pain and the time it takes people to seek treatment. Miller said these differences may make the risk assessment tools inaccurate if they are applied to other population groups.
"What we found was that in Singapore, patients were less likely to exhibit the typical symptom of heart attack: chest pain.” Miller said. "Age and male gender also had little predictive power in evaluating whether these patients were having a heart attack.”
Miller said the results suggest that doctors should consciously consider the effects of racial or ethnic differences when they use the tools. "Given the previously demonstrated differences in ethnic groups, combined with our findings, one must question the utility of population-based cardiac risk assessment.”
MEDICA.de; Source: Wake Forest University Baptist Medical Center