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Titolo:
A systematic review of troponin T and I for diagnosing acute myocardial infarction
Autore:
Ebell, MH; Flewelling, D; Flynn, CA;
Indirizzi:
Michigan State Univ, Dept Family Practice, E Lansing, MI 48824 USA Michigan State Univ E Lansing MI USA 48824 ctice, E Lansing, MI 48824 USA Kalamazoo Coll, Kalamazoo, MI 49007 USA Kalamazoo Coll Kalamazoo MI USA 49007 mazoo Coll, Kalamazoo, MI 49007 USA SUNY Syracuse, Upstate Med Univ, Dept Family Med, Syracuse, NY USA SUNY Syracuse Syracuse NY USA ed Univ, Dept Family Med, Syracuse, NY USA
Titolo Testata:
JOURNAL OF FAMILY PRACTICE
fascicolo: 6, volume: 49, anno: 2000,
pagine: 550 - 556
SICI:
0094-3509(200006)49:6<550:ASROTT>2.0.ZU;2-F
Fonte:
ISI
Lingua:
ENG
Soggetto:
RAPID BEDSIDE ASSAY; CREATINE-KINASE-MB; BIOCHEMICAL MARKERS; CHEST PAIN; EMERGENCY; IMMUNOASSAY; PERFORMANCE; EXCLUSION; ADMISSION;
Keywords:
troponin; myocardial infarction; critical care; chest pain;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
24
Recensione:
Indirizzi per estratti:
Indirizzo: Ebell, MH Michigan State Univ, Dept Family Practice, B101 Clin Ctr, E Lansing, MI 48824 USA Michigan State Univ B101 Clin Ctr E Lansing MI USA 48824 824 USA
Citazione:
M.H. Ebell et al., "A systematic review of troponin T and I for diagnosing acute myocardial infarction", J FAM PRACT, 49(6), 2000, pp. 550-556

Abstract

OBJECTIVE Elevations of serum troponin T and I values are being used to diagnose acute myocardial infarction (AMI) and to rule out the condition in patients before their discharge from the emergency department (ED). However,the sensitivity and specificity of these tests vary considerably. Our goalwas to systematically review the data on the accuracy of troponin T and I for the diagnosis of AMI in the ED. SEARCH STRATEGY We searched the MEDLINE database using the following strategy: troponin (text word) and diagnosis (medical subject heading [MeSH]) ortroponin/diagnostic use (MeSH). The references of articles meeting our inclusion criteria were searched for additional articles. SELECTION CRITERIA We evaluated each study for quality. Only prospective blinded cohort studies with an adequate reference standard were included in the analysis. DATA COLLECTION/ANALYSIS. Data from each study were abstracted by 2 investigators. We graphed sensitivity and specificity for different points in time from arrival in the ED or from the onset of pain and calculated summary estimates when appropriate and possible. MAIN RESULTS Sensitivity increases for both troponin T and I from 10% to 45% within 1 hour of the onset of pain (depending on the cut-off) to more than 90% at 8 or more hours. Specificity declines gradually from 87% to 80% from 1 to 12 hours after the onset of chest pain for troponin T and is approximately 95% fur troponin I. The peak abnormal value in the first 24 hours after admission to the ED has an area under the receiver operating characteristic curve of 0.99 and is very useful at ruling out AMI if negative. CONCLUSIONS Although troponin T and I values are useful tools for the diagnosis of AMI, they must be interpreted according to the number of hours from the onset of chess pain, The test is particularly useful at ruling out MIwhen the value is negative at 8 or more hours after the onset of chest pain.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 29/09/20 alle ore 00:42:58