to determine if these patients with early symptoms were being treated the same as patients who were known to be having a heart attack, or if the doctors were waiting for elevated heart markers before beginning treatment,” said Miller. “Our findings suggest that doctors were treating both of these high-risk patient groups the same and were not waiting for the heart markers to elevate.”

The results showed that in both groups that had heart attacks, doctors treated patients with aspirin and other blood-thinning medications. The groups also had similar rates of angioplasty, a procedure to open blocked arteries, and surgery to “bypass” blocked arteries.

Miller said the results suggest that doctors are using other immediately available data, such as information from the patient's history and electrocardiogram, to make treatment decisions.

The researchers also found that those patients who were having an “evolving” heart attack were 19 percent less likely to die or have a second heart attack within 30 days than patients who were immediately diagnosed with a heart attack. Although the exact reason for this finding cannot be determined from this research, this finding could be due to earlier treatment, said Miller. The patients with “evolving” heart attacks came to the emergency department a median of 1.7 hours after their symptoms developed, compared to 4 hours for those whose heart attack markers had already increased.

Of the 8,312 patients in the study, 66 percent were diagnosed with a heart attack at enrollment, 20 percent had an “evolving” heart attack that showed up on lab tests within 12 hours and 13 percent of participants didn’t have elevated markers within 12 hours.

The research was an analysis of a larger trial, the Superior Yield of the New strategy of Enoxaparin, Revascularization, and GlYcoprotein IIb/IIIa inhibitors (SYNERGY) trial. The study included patients who met two of the following criteria:
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