Biochemical markers of ischaemia for the early identification of acute myocardial infarction without ST segment elevation

被引:38
作者
Haastrup, B
Gill, S
Kristensen, SR
Jorgensen, PJ
Glatz, JFC
Haghfelt, T
Horder, M
机构
[1] Odense Univ Hosp, Dept Cardiol, Odense C, Denmark
[2] Odense Univ Hosp, Dept Clin Biochem & Genet, Odense C, Denmark
[3] Cardiovasc Res Inst Maastricht, Maastricht, Netherlands
关键词
acute myocardial infarction; early diagnosis; biochemical markers of ischaemia;
D O I
10.1159/000047326
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Blood was collected on admission and after 1-2 h in 130 consecutive patients admitted with typical chest pain in order to assess the capacity of myoglobin, fatty-acid-binding protein (FABP), CK-MB mass, and troponin I (Tnl) in the early identification of acute myocardial infarction (AMI) without ST elevation. Using the maximum value within 6 h of onset of symptoms, AMI was detected with a 90-95% sensitivity and a 81-94% specificity by FABP at a cut-off level 8-12 mug/l, or 81-86% and 89-93%, respectively, by myoglobin at a cut-off level 70-90 mug/l. CK-MB mass and Tnl had low sensitivity, albeit very high specificity. As almost all AMI patients were identified within 6 h, serial measurements of FABP or myoglobin ruled out AMI with a very high degree of certainty. Due to the low prevalence of AMI (16%), the positive predictive values were modest (47-73%), yet increasing the probability of AMI by a factor 3-4. Myoglobin and FABP are very useful markers in the early triage of chest pain patients. Copyriyht (C) 2001 S. Karger AG, Basel.
引用
收藏
页码:254 / 261
页数:8
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