OBJECTIVES: To investigate the impact of the redefinition of the diagnostic criteria for myocardial infarction on its apparent incidence in a non-selected and representative series of patients admitted with acute chest pain. DESIGN: Single centre prospective study. SETTING: Medical assessment unit and cardiology wards of an inner city university hospital. PATIENTS: 80 consecutive patients aged over 25 years admitted with suspected ischaemic acute chest pain (excluding those where the ECG indicated definite myocardial infarction). INTERVENTIONS: Measurement of concentrations of conventional cardiac biomarkers (creatine kinase and its MB isoenzyme, CK-MB) and concentrations of the highly specific diagnostic indicator of myocardial damage, cardiac troponin I (cTnI) 12-24 hours after the onset of acute chest pain. MAIN OUTCOME MEASURES: Frequency of myocardial infarction as assessed by conventional diagnostic criteria (creatine kinase and CK-MB) plus clinical symptoms of infarction, versus frequency of infarction based on high sensitivity troponin assays. RESULTS: Among patients with acute coronary syndromes but non-diagnostic ECG changes, 40% (32/80) fulfilled the new criteria for myocardial infarction using high sensitivity cTnI measurement, compared with 29% (23/80) using the conventional diagnostic criteria for myocardial infarction. CONCLUSIONS: The implications of the redefinition of myocardial infarction on patients, their care, and the use of health care resources are substantial.
OBJECTIVES: To investigate the impact of the redefinition of the diagnostic criteria for myocardial infarction on its apparent incidence in a non-selected and representative series of patients admitted with acute chest pain. DESIGN: Single centre prospective study. SETTING: Medical assessment unit and cardiology wards of an inner city university hospital. PATIENTS: 80 consecutive patients aged over 25 years admitted with suspected ischaemic acute chest pain (excluding those where the ECG indicated definite myocardial infarction). INTERVENTIONS: Measurement of concentrations of conventional cardiac biomarkers (creatine kinase and its MB isoenzyme, CK-MB) and concentrations of the highly specific diagnostic indicator of myocardial damage, cardiac troponin I (cTnI) 12-24 hours after the onset of acute chest pain. MAIN OUTCOME MEASURES: Frequency of myocardial infarction as assessed by conventional diagnostic criteria (creatine kinase and CK-MB) plus clinical symptoms of infarction, versus frequency of infarction based on high sensitivity troponin assays. RESULTS: Among patients with acute coronary syndromes but non-diagnostic ECG changes, 40% (32/80) fulfilled the new criteria for myocardial infarction using high sensitivity cTnI measurement, compared with 29% (23/80) using the conventional diagnostic criteria for myocardial infarction. CONCLUSIONS: The implications of the redefinition of myocardial infarction on patients, their care, and the use of health care resources are substantial.
Authors: M Galvani; F Ottani; D Ferrini; J H Ladenson; A Destro; D Baccos; F Rusticali; A S Jaffe Journal: Circulation Date: 1997-04-15 Impact factor: 29.690
Authors: J P Bertinchant; C Larue; I Pernel; B Ledermann; P Fabbro-Peray; L Beck; C Calzolari; S Trinquier; J Nigond; B Pau Journal: Clin Biochem Date: 1996-12 Impact factor: 3.281
Authors: E Brscic; I Chiappino; S Bergerone; G Lanfranco; L Mainardi; M Imazio; C Amellone; R Pagni; E Rosettani Journal: Am J Cardiol Date: 1998-10-15 Impact factor: 2.778
Authors: E M Antman; M J Tanasijevic; B Thompson; M Schactman; C H McCabe; C P Cannon; G A Fischer; A Y Fung; C Thompson; D Wybenga; E Braunwald Journal: N Engl J Med Date: 1996-10-31 Impact factor: 91.245
Authors: Andrew E Moran; Mohammad H Forouzanfar; Gregory A Roth; George A Mensah; Majid Ezzati; Abraham Flaxman; Christopher J L Murray; Mohsen Naghavi Journal: Circulation Date: 2014-02-26 Impact factor: 29.690