Document Detail


Rapid risk stratification in suspected acute coronary syndrome using serial multiple cardiac biomarkers: a pilot study.
MedLine Citation:
PMID:  18973637     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To determine the feasibility of using a biomarker panel of myoglobin, creatinine kinase MB (CK-MB) and cardiac troponin I (cTnI) to identify patients with suspected acute coronary syndrome (ACS) who are suitable for discharge within 2 h. METHODS: We took blood at presentation and at 2 h from patients with suspected ACS and non-diagnostic electrocardiogram who were admitted to the ED short stay ward for serial electrocardiogram and troponin testing. We used a point-of-care device that gives rapid estimation of myoglobin, CK-MB and cTnI (Triage cardiac panel). These results were compared with the results of our standard hospital cardiac troponin T assay. Patients were followed up by telephone at 30 days. RESULTS: The study group comprised 100 patients (61 men) with mean age of 58 years. Six had a troponin-positive ACS during their ED stay. One additional patient died of a myocardial infarction within the follow-up period. The Triage panel at 2 h after presentation predicted 12-h cardiac troponin T elevation (sensitivity 100%, negative predictive value 99%) and 30-day events (sensitivity 86%, negative predictive value 97%). The majority of patients were ultimately suitable for discharge. CONCLUSION: Serial myoglobin, CK-MB and cTnI have the potential to identify patients who are suitable for early discharge and outpatient work-up. A large multicentre study is required.
Authors:
Stephen P J Macdonald; Yusuf Nagree
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Emergency medicine Australasia : EMA     Volume:  20     ISSN:  1742-6723     ISO Abbreviation:  Emerg Med Australas     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-31     Completed Date:  2009-03-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101199824     Medline TA:  Emerg Med Australas     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  403-9     Citation Subset:  IM    
Affiliation:
Emergency Department, Armadale Health Service, Armadale, Western Australia, Australia. stephen.macdonald@health.wa.gov.au
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MeSH Terms
Descriptor/Qualifier:
Acute Coronary Syndrome / blood,  diagnosis*,  physiopathology
Biological Markers / blood
Chest Pain / blood,  etiology
Creatine Kinase, MB Form / blood*
Diagnosis, Differential
Female
Humans
Male
Middle Aged
Pilot Projects
Point-of-Care Systems*
Risk Assessment
Sensitivity and Specificity
Triage / methods*
Troponin I / blood*
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Troponin I; EC 2.7.3.2/Creatine Kinase, MB Form
Comments/Corrections
Comment In:
Emerg Med Australas. 2008 Oct;20(5):382-3   [PMID:  18973634 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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