Acute Myocardial Infarction Market Segment

Acute Myocardial Infarction Market Segment

Each year in the US, about 6 million patients are evaluated for acute chest pain in emergency departments and chest pain facilities. About 20% or more will prove to have acute coronary syndrome (ACS), a term that encompasses acute myocardial infarction and related conditions.

The evaluation of acute chest pain involves enormous stakes. An incorrect discharge of an ACS patient triples the likelihood of death relative to one who is properly admitted. At the same time, about 70% of patients admitted for chest pain have a non-cardiac cause for their symptoms. Such unnecessary admissions cost about $5 billion annually in the United States.

The initial evaluation of patients with acute chest pain involves only the history and physical and results from a standard ECG (Selker et al, 1997; Welch et al, 2001; Braunwald et al., 2002). Cardiac biomarkers and various imaging modalities have important diagnostic roles, but none of them can replace the ECG as the universal, quickly available screening tool.

At present, the ECG's diagnostic limitations are the single largest source of diagnostic error in ACS. The initial ECG may be negative in up to half of ACS patients. The problem is most evident when the acute event involves remote areas of the heart, such as the lateral or posterior wall. These areas are particularly difficult for the standard ECG to detect.

Delays in accurate diagnosis are not only costly, but can be fatal. One-fourth of patients with ischemic-like chest pain die as the result of an infarction. Earlier and more accurate diagnosis allows treatment within the critical first two hours when it is known to be most beneficial. Beside ECG, there are various technologies (stress test, echocardiogram, thallium scanning, body surface mapping – MAP, etc.) for identifying acute cardiac ischemia. Some of them have high diagnostic performance, but due to their complexity or high cost have modest or negligible clinical impact in the emergency department practice. Therefore, there is a large unmet need for rapid, more accurate, and more definitive diagnoses of AMI in ERs.