Welcome to The Medical Pipeline (TMP). The Medical Pipeline features topics that put you at the forefront of device, diagnostic, and drug research and development. Our feature report focuses on Acute coronary syndrome.

Diagnosing patients with chest pain who present to the emergency department continues to be a challenge. Most patients do not have acute coronary syndrome (ACS) and are sent home. In about 2% of these patients, the diagnosis of ACS is missed, and this is a major cause of liability in the emergency department.

Diagnostic products in the pipeline designed to more accurately identify ACS include biomarkers and imaging products. Biomarkers being investigated include myeloperoxidase, myeloid-related protein-8/14, and an ultrasensitive cardiac troponin I assay. A 64-slice multidetector computed tomography (MDCT) has gained interest as a diagnostic device. In addition, we report on progress in the development of AMISCAN™ (a technetium-99M—labeled derivative of D-glucaric acid) and Zemiva™ (iodofiltic acid I-123—ß-methyl-p-iodophenylpentadecanoic acid), which is to be used with single-photon emission computed tomography.

Our Thought Leaders' key concerns are time and accuracy of the ACS diagnosis in the emergency department. Patients who do have ACS need to be treated rapidly to preserve heart-muscle function. Admitting all patients with suspected ACS to an observation unit or the intensive care unit has serious resource and cost implications. Thus, new methods to achieve a timely, accurate diagnosis of ACS could be very valuable for patients, providers, and payers.

 

Marjorie Pestel Zimmerman