Literature DB >> 10361049

Ruling out acute myocardial infarction early with two serial creatine kinase-MBmass determinations.

R J de Winter1, R Bholasingh, A B Nieuwenhuijs, R W Koster, R J Peters, G T Sanders.   

Abstract

AIMS: We studied the diagnostic value for acute myocardial infarction of serial creatine kinase-MBmass measurements on admission and at 7 h after the onset of symptoms. METHODS AND
RESULTS: Patients presenting to our chest pain unit with symptoms of <5-h duration were eligible. Patients were kept under observation at least until 12 h after onset of symptoms. Blood samples were drawn on admission and 7 and 10 h after onset of symptoms. Creatine kinase-MBmass>7.0 microg x 1(-1) (upper reference limit for acute myocardial infarction), or an increase >2.0 microg x 1(-1) (reference change value) between admission and at 7 h was considered abnormal. Of a total of 470 patients, 248 patients had acute myocardial infarction: 100 out of the 248 patients had a single creatine kinase-MBmass>7.0 microg x 1(-1) on admission (sensitivity 40%, 95% CI:34-46%), 234/248 patients at 7 h (sensitivity 94%, 95% CI:91-97%), and 240/248 at 10 h (sensitivity 97%, 95% CI:94-99%). At 7 h, 246/248 patients had either a single creatine kinase-MB >7.0 microg x 1(-1) or a significant increase between admission and 7 h (sensitivity 99%, 95% CI:98-100%). Of 222 patients without acute myocardial infarction, 214 had a normal serial creatine kinase-MBmass (specificity 96%, 95% CI:93-98%).
CONCLUSION: In patients with symptoms of <5-h duration, acute myocardial infarction can be ruled out using serial creatine kinase-MBmass taken on admission and at 7 h. Copyright 1999 The European Society of Cardiology.

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Year:  1999        PMID: 10361049     DOI: 10.1053/euhj.1998.1449

Source DB:  PubMed          Journal:  Eur Heart J        ISSN: 0195-668X            Impact factor:   29.983


  4 in total

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Journal:  Trans Am Clin Climatol Assoc       Date:  2004

2.  Safe discharge from the cardiac emergency room with a rapid rule-out myocardial infarction protocol using serial CK-MB(mass).

Authors:  R Bholasingh; R J de Winter; J C Fischer; R W Koster; R J Peters; G T Sanders
Journal:  Heart       Date:  2001-02       Impact factor: 5.994

3.  Clinical, electrocardiographic, and biochemical data for immediate risk stratification in acute coronary syndromes.

Authors:  S Savonitto; R Fusco; C B Granger; M G Cohen; T D Thompson; D Ardissino; R M Califf
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4.  Acute chest pain--identification of patients at low risk for coronary events. The impact of symptoms, medical history and risk factors.

Authors:  Martin Schillinger; Gottfried Sodeck; Giora Meron; Karin Janata; Mariam Nikfardjam; Fritz Rauscha; Anton N Laggner; Hans Domanovits
Journal:  Wien Klin Wochenschr       Date:  2004-02-16       Impact factor: 1.704

  4 in total

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