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Titolo:
Biochemical markers in the management of suspected acute myocardial infarction in the emergency department
Autore:
Huggon, AM; Chambers, J; Nayeem, N; Tutt, P; Crook, M; Swaminathan, S;
Indirizzi:
Guys Hosp, Dept Accid & Emergency, London SE1 9RT, England Guys Hosp London England SE1 9RT id & Emergency, London SE1 9RT, England St Thomas Hosp, Dept Accid & Emergency, London, England St Thomas Hosp London England , Dept Accid & Emergency, London, England Guys Hosp, Dept Cardiol, London SE1 9RT, England Guys Hosp London England SE1 9RT , Dept Cardiol, London SE1 9RT, England St Thomas Hosp, Dept Cardiol, London, England St Thomas Hosp London England homas Hosp, Dept Cardiol, London, England Guys Hosp, Dept Clin Biochem, London SE1 9RT, England Guys Hosp London England SE1 9RT t Clin Biochem, London SE1 9RT, England St Thomas Hosp, Dept Clin Biochem, London, England St Thomas Hosp LondonEngland Hosp, Dept Clin Biochem, London, England
Titolo Testata:
EMERGENCY MEDICINE JOURNAL
fascicolo: 1, volume: 18, anno: 2001,
pagine: 15 - 19
SICI:
1472-0205(200101)18:1<15:BMITMO>2.0.ZU;2-P
Fonte:
ISI
Lingua:
ENG
Soggetto:
CARDIAC TROPONIN-T; CHEST PAIN; CREATINE-KINASE; EARLY DIAGNOSIS; CK-MB; RISK STRATIFICATION; UNSTABLE ANGINA; MYOGLOBIN; ELECTROCARDIOGRAM; IMMUNOASSAY;
Keywords:
acute myocardial infarction; cardiac enzyme; troponin T; myoglobin; CKMB mass;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
25
Recensione:
Indirizzi per estratti:
Indirizzo: Huggon, AM Univ London, Lewisham Hosp, Dept Accid & Emergency, Lewisham High St, London SE13 6LH, England Univ London Lewisham High St London England SE13 6LH , England
Citazione:
A.M. Huggon et al., "Biochemical markers in the management of suspected acute myocardial infarction in the emergency department", EMERG MED J, 18(1), 2001, pp. 15-19

Abstract

Objectives-To compare cardiac troponin T, myoglobin, CK, CKMB activity, CKMB mass and the initial electrocardiogram in the early diagnosis of myocardial infarction in the emergency department. Methods-Biochemical markers were measured at presentation in patients witha possible diagnosis of acute myocardial infarction. Based on the clinicalnotes, patients were grouped as "definite myocardial infarction" (n = 50),"definite no myocardial infarction" (n = 81) and "uncertain" (n = 96). Sensitivity and specificity and positive and negative predictive values were calculated using the 131 patients with definitely present or absent myocardial infarction. Results-The initial electrocardiogram was more sensitive than any of the markers in the first six hours from symptom onset-sensitivity 74% (95%CI61% to 88%). The positive predictive value of the initial electrocardiogram was97% in the first six hours; the markers ranged from 47% to 67%. The negative predictive value of the initial electrocardiogram was 85% in the first six hours; the markers ranged from 61% to 70%. Four patients with nondiagnostic electrocardiograms presenting beyond six hours after pain onset had a myocardial infarct detected by at least three of the biochemical markers in each case. Conclusions-The electrocardiogram is of more diagnostic use than biochemical markers in the first six hours after the onset of pain, but biochemical markers give additional positive diagnostic information in patients presenting later than this. The negative predictive accuracy of biochemical markers is too low for a single sample to be useful for excluding myocardial infarction in the first six hours after onset of symptoms.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 22/01/20 alle ore 19:10:29