Document Detail


Predictors of myocardial damage prior to hospital admission among patients with acute chest pain or other symptoms raising a suspicion of acute coronary syndrome.
MedLine Citation:
PMID:  12702926     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: To evaluate factors which, prior to hospital admission, predict the development of acute coronary syndrome or acute myocardial infarction among patients who call for an ambulance due to suspected acute coronary syndrome. DESIGN: Prospective observational study. METHODS: All the patients who called for an ambulance due to suspected acute coronary syndrome in South Hospital's catchment area in Stockholm and in the Municipality of Göteborg between January and November 2000, were included. On arrival of the ambulance crew, a blood sample was drawn for bedside analysis of serum myoglobin, creatine kinase (CK)MB and troponin-I. A 12-lead electrocardiogram (ECG) was simultaneously recorded. RESULTS: In all, 538 patients took part in the survey. Their mean age was 69 years and 58% were men. In all, 307 patients (57.3%) had acute coronary syndrome and 158 (29.5%) had acute myocardial infarction. Independent predictors of the development of acute coronary syndrome were a history of myocardial infarction (P=0.006), angina pectoris (P=0.005) or hypertension (P=0.017), ECG changes with ST elevation (P<0.0001), ST depression (P<0.0001) or T-wave inversion (P=0.012) and the elevation of CKMB (P=0.005). Predictors of acute myocardial infarction were being a man (P=0.011), ECG changes with ST elevation (P<0.0001) or ST depression (P<0.0001), the elevation of CKMB (P<0.0001) and a short interval between the onset of symptoms and blood sampling (P=0.010). CONCLUSION: Among patients transported by ambulance due to suspected acute coronary syndrome, predictors of myocardial damage can be defined prior to hospital admission on the basis of previous history, sex, ECG changes, the elevation of biochemical markers and the interval from the onset of symptoms until the ambulance reaches the patient.
Authors:
Leif Svensson; Leif Isaksson; Christer Axelsson; Rolf Nordlander; Johan Herlitz
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  Coronary artery disease     Volume:  14     ISSN:  0954-6928     ISO Abbreviation:  Coron. Artery Dis.     Publication Date:  2003 May 
Date Detail:
Created Date:  2003-04-18     Completed Date:  2003-09-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9011445     Medline TA:  Coron Artery Dis     Country:  England    
Other Details:
Languages:  eng     Pagination:  225-31     Citation Subset:  IM    
Affiliation:
Division of Cardiology, South Hospital, SE-118 83 Stockholm, Sweden. leif.svensson@sos.sll.se.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Ambulances
Biological Markers / blood
Chest Pain / blood,  epidemiology,  therapy*
Coronary Disease / blood,  epidemiology,  therapy*
Creatine Kinase / blood
Creatine Kinase, MB Form
Electrocardiography, Ambulatory
Female
Humans
Isoenzymes / blood
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / blood,  epidemiology,  therapy*
Patient Admission*
Predictive Value of Tests
Prevalence
Risk Factors
Sweden / epidemiology
Syndrome
Treatment Outcome
Troponin I / blood
Troponin T / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Isoenzymes; 0/Troponin I; 0/Troponin T; EC 2.7.3.2/Creatine Kinase; EC 2.7.3.2/Creatine Kinase, MB Form

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