Jamal A Alhashemi1. 1. Department of Anesthesia and Critical Care, King Abdulaziz University, King Abdulaziz University Hospital, Jeddah, Saudi Arabia. jalhashemi@kau.edu.sa
Abstract
OBJECTIVE: To evaluate the diagnostic efficacy of a bedside immunochromatographic test (CardioDetect) that identifies human heart-type fatty acid-binding protein in whole blood. METHODS: Sixty-four patients with chest pain had CardioDetect test performed together with serial determination of serum troponin I (TnI) and creatine kinase (CK). CardioDetect results were interpreted twice, 24 hours apart, by 3 independent observers who were blinded to patients' clinical and laboratory data. Acute myocardial infarction was diagnosed by a physician blinded to the results of the CardioDetect test. Sensitivity, specificity, positive and negative predictive values, diagnostic accuracy, and receiver operating characteristic curves were determined for all tests at 4 predefined times. Intraobserver and interobserver reliabilities were determined. RESULTS: At less than 4 hours after chest pain, CardioDetect had a sensitivity and specificity of 62.5% and 100% compared with 50% and 80% for TnI and 37.5% and 80% for CK, respectively. At more than 4 hours but 12 hours or less in duration, the sensitivity of CardioDetect and TnI was 100%, whereas that of CK was 85.7%. Intraobserver agreement and interobserver reliability were high for CardioDetect (kappa >0.80 [P < .0001] and intraclass correlation coefficient, >0.90, respectively). CONCLUSION: CardioDetect was a reliable point-of-care test for the early diagnosis (<12 hours) of acute myocardial infarction in the ED.
OBJECTIVE: To evaluate the diagnostic efficacy of a bedside immunochromatographic test (CardioDetect) that identifies human heart-type fatty acid-binding protein in whole blood. METHODS: Sixty-four patients with chest pain had CardioDetect test performed together with serial determination of serum troponin I (TnI) and creatine kinase (CK). CardioDetect results were interpreted twice, 24 hours apart, by 3 independent observers who were blinded to patients' clinical and laboratory data. Acute myocardial infarction was diagnosed by a physician blinded to the results of the CardioDetect test. Sensitivity, specificity, positive and negative predictive values, diagnostic accuracy, and receiver operating characteristic curves were determined for all tests at 4 predefined times. Intraobserver and interobserver reliabilities were determined. RESULTS: At less than 4 hours after chest pain, CardioDetect had a sensitivity and specificity of 62.5% and 100% compared with 50% and 80% for TnI and 37.5% and 80% for CK, respectively. At more than 4 hours but 12 hours or less in duration, the sensitivity of CardioDetect and TnI was 100%, whereas that of CK was 85.7%. Intraobserver agreement and interobserver reliability were high for CardioDetect (kappa >0.80 [P < .0001] and intraclass correlation coefficient, >0.90, respectively). CONCLUSION:CardioDetect was a reliable point-of-care test for the early diagnosis (<12 hours) of acute myocardial infarction in the ED.
Authors: Jochen D Muehlschlegel; Tjörvi E Perry; Kuang-Yu Liu; Amanda A Fox; Charles D Collard; Stanton K Shernan; Simon C Body Journal: Anesth Analg Date: 2010-05-10 Impact factor: 5.108
Authors: Kyung Su Kim; Hui Jai Lee; Kyuseok Kim; You Hwan Jo; Tae Yun Kim; Jin Hee Lee; Joong Eui Rhee; Gil Joon Suh; Mi Ran Kim; Christopher C Lee; Adam J Singer Journal: J Korean Med Sci Date: 2010-12-22 Impact factor: 2.153