Bracelet Sensor Evaluated to Assess Troponin Levels for Diagnosing Heart Attacks

March 6, 2023—The American College of Cardiology announced that an experimental wrist-worn device was found to predict troponin-I and obstructed arteries with 90% accuracy in 5 minutes in a multicenter real-world clinical trial.

According to ACC, the study investigators believe that the new device could help augment the common diagnostic process for diagnosing heart attacks—assessment of drawn blood for the troponin-I protein—by providing an early assessment of the likelihood that a patient is having a heart attack before lab results are available.

The wrist-worn sensor uses infrared light to detect the presence of troponin-I in the blood through the skin. The device sends signals via Bluetooth to a cloud-based system, where a machine learning algorithm relates the information to training data to predict the wearer’s troponin level. The study was funded by RCE Technologies Inc., the developer of the experimental troponin sensor.

Partho P. Sengupta, MD, presented “A Novel Breakthrough in Wrist-Worn Transdermal Troponin-I-Sensor Assessment for Acute Myocardial Infarction” at ACC.23/WCC, the ACC’s annual scientific session together with the World Congress of Cardiology held March 4-6, 2023, in New Orleans, Louisiana. The study was simultaneously published by Shantanu Sengupta, MD, et al online in the European Heart Journal Digital Health.

Dr. Partho Sengupta, who is Professor of Cardiology at Rutgers Robert Wood Johnson Medical School and chief of the cardiovascular service line at Robert Wood Johnson University Hospital in New Brunswick, New Jersey, commented in the ACC press release, “This is an exciting opportunity because it increases our capability for early diagnosis of heart attacks in both community settings and in acute care environments. There’s still a lot of work to be done, but this approach could potentially address access issues and prioritization issues, for example by shortening the time to triage or being used by emergency responders to plan the patient’s journey before they even arrive at the hospital.”

As summarized in the ACC press release, the study investigators enrolled 239 patients who were suspected of experiencing a heart attack at five sites in India. All patients wore the wrist-based sensor and underwent a blood draw to assess troponin-I levels, an electrocardiogram to record the heart’s electrical signals, and either an echocardiogram or coronary angiogram to image blood flow through the heart. The investigators used data from the first three sites to train the machine-learning model and then used the remaining two sites to test the model’s accuracy.

The investigators reported that the results indicated that the system predicts troponin-I levels with approximately 90% accuracy. In addition, the findings correlated well with clinical evidence of a heart attack; patients with abnormal troponin levels as measured by the device were approximately four times as likely to have an obstructed artery compared to patients with a negative troponin result as measured by the device.

“With this level of accuracy, if you use this device and it comes out positive, you’re fairly sure this patient can be admitted for fast-tracking diagnostic tests, treatment, and intervention,” stated Dr. Sengupta in the ACC press release.

According to ACC, the investigators cautioned that more studies are needed to further validate and refine the system, including studies to determine whether biological variability—such as differences in skin tone, wrist size, skin health, or other factors—could affect the device’s performance. In addition, they plan to study whether including the detected troponin value (rather than simply the presence or absence of a threshold value) or providing continuous measurements could enhance the device’s usefulness in clinical settings.

The investigators noted that the patients included in the trial were hospitalized but were not being treated in the emergency room. They said that testing the device in emergency room settings would be helpful moving forward. They added that the wearable sensor technology could potentially be adapted for aiding triage and diagnosis for a variety of cardiovascular diseases and other health problems.

Dr. Sengupta concluded in the ACC press release, “Transdermal infrared-based techniques open up a tremendous potential for bloodless biomarker assessment. We have started with troponin, but the journey is going to continue because it is possible to use this technology for other biomarkers. This is just the start.”