EXCLUSION OF ACUTE MYOCARDIAL-INFARCTION - THE VALUE OF MEASURING CREATINE-KINASE SLOPE

被引:0
作者
BAKKER, AJ
KOELEMAY, MJW
VANVLIES, B
GORGELS, JPMC
SMITS, R
TIJSSEN, JGP
HAAGEN, FDM
机构
[1] MED CTR LEEUWARDEN,DEPT CARDIOL,LEEUWARDEN,NETHERLANDS
[2] UNIV AMSTERDAM,ACAD MED CTR,DEPT CLIN CHEM,1105 AZ AMSTERDAM,NETHERLANDS
[3] UNIV AMSTERDAM,ACAD MED CTR,DEPT CARDIOL,1105 AZ AMSTERDAM,NETHERLANDS
[4] UNIV AMSTERDAM,ACAD MED CTR,DEPT CLIN EPIDEMIOL & BIOSTAT,1105 AZ AMSTERDAM,NETHERLANDS
来源
EUROPEAN JOURNAL OF CLINICAL CHEMISTRY AND CLINICAL BIOCHEMISTRY | 1995年 / 33卷 / 06期
关键词
D O I
暂无
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
For the exclusion (and diagnosis) of acute myocardial infarction, we studied timed sequential (slope) measurements of creatine kinase and creatine kinase-MB catalytic activity concentration, creatine kinase-MB mass concentration, troponin T and myoglobin, using data from 242 patients consecutively admitted for evaluation of suspected acute myocardial infarction in the 12 hours before admission. Three biochemical strategies based on measurements in two consecutive samples obtained within 12 hours after admission were evaluated. The highest sensitivities were encountered for a biochemical strategy based on the sole measurement of creatine kinase mass concentration (98%) or troponin T (96%) and a strategy based on measurements of creatine kinase activity concentrations, which includes creatine kinase slope calculation and measurement of creatine kinase mass concentration (95%). Both strategies were applied in subgroups of patients based on the electrocardiographic findings. In patients with a normal electrocardiogram, the sensitivity of the strategy using sole measurements of creatine kinase mass concentration was 100%, but this was also true for the strategy based on creatine kinase slope measurements, which is the cheaper and therefore preferred procedure for excluding myocardial infarction. This approach, however, does not account for detecting minor myocardial cell damage in patients not yet fulfilling the criteria of the World Health Organization for diagnosing acute myocardial infarction.
引用
收藏
页码:351 / 363
页数:13
相关论文
共 45 条
  • [1] EARLIEST ELECTROCARDIOGRAPHIC EVIDENCE OF MYOCARDIAL-INFARCTION - IMPLICATIONS FOR THROMBOLYTIC TREATMENT
    ADAMS, J
    TRENT, R
    RAWLES, J
    [J]. BMJ-BRITISH MEDICAL JOURNAL, 1993, 307 (6901): : 409 - 413
  • [2] FAILURE OF NEW BIOCHEMICAL MARKERS TO EXCLUDE ACUTE MYOCARDIAL-INFARCTION AT ADMISSION
    BAKKER, AJ
    KOELEMAY, MJW
    GORGELS, JPMC
    VANVLIES, B
    SMITS, R
    TIJSSEN, JGP
    HAAGEN, FDM
    [J]. LANCET, 1993, 342 (8881) : 1220 - 1222
  • [3] BAKKER AJ, 1993, CLIN CHEM, V39, P653
  • [4] BAKKER AJ, 1993, EUR J CLIN CHEM CLIN, V31, P715
  • [5] VALUE OF ADMISSION ELECTROCARDIOGRAM IN PREDICTING OUTCOME OF THROMBOLYTIC THERAPY IN ACUTE MYOCARDIAL-INFARCTION - A RANDOMIZED TRIAL CONDUCTED BY THE NETHERLANDS-INTERUNIVERSITY-CARDIOLOGY-INSTITUTE
    BAR, FW
    VERMEER, F
    DEZWAAN, C
    RAMENTOL, M
    BRAAT, S
    SIMOONS, ML
    HERMENS, WT
    VANDERLAARSE, A
    VERHEUGT, FWA
    KRAUSS, XH
    WELLENS, HJJ
    [J]. AMERICAN JOURNAL OF CARDIOLOGY, 1987, 59 (01) : 6 - 13
  • [6] BRANDT DR, 1990, CLIN CHEM, V36, P375
  • [7] BRAUN HP, 1990, CLIN CHEM, V36, P1129
  • [8] BVAKKER AJ, 1994, EUR HEART J, V15, P45
  • [9] CAIRNS JA, 1983, CLIN CHEM, V29, P469
  • [10] EARLY DIAGNOSIS OF ACUTE MYOCARDIAL-INFARCTION BY CK-MB MASS MEASUREMENTS
    COLLINSON, PO
    ROSALKI, SB
    KUWANA, T
    GARRATT, HM
    RAMHAMADAMY, EM
    BAIRD, IM
    GREENWOOD, TW
    [J]. ANNALS OF CLINICAL BIOCHEMISTRY, 1992, 29 : 43 - 47