BACKGROUND: To rule out acute myocardial infarction (AMI) in chest pain patients constitutes a diagnostic challenge to emergency department (ED) physicians. STUDY OBJECTIVES: To evaluate the diagnostic value of measuring salivary alpha-amylase (sAA) activity for detecting AMI in patients presenting to the ED with acute chest pain. METHODS: sAA activity was measured in a prospective cohort of 473 consecutive adult patients within 4 h of onset of chest pain. Comparisons were made between patients with a final diagnosis of AMI and those with non-AMI. Univariate analysis and multiple logistic regression model were used to identify independent clinical predictors of AMI. RESULTS: Initial sAA activity in the AMI group (n = 85; 266 ± 127.6 U/mL) was significantly higher than in the non-AMI group (n = 388; 130 ± 92.8 U/mL, p < 0.001). sAA activity levels were also significantly higher in patients with ST elevation AMI (n = 53) compared to in those with non-ST elevation AMI (n = 32) (300 ± 141.1 vs. 210 ± 74.1 U/mL, p < 0.001). The area under the receiver operating characteristic curve of sAA activity for predicting AMI in patients with acute chest pain was 0.826 (95% confidence interval [CI] 0.782-0.869), with diagnostic odds ratio 10.87 (95% CI 6.16-19.18). With a best cutoff value of 197.7 U/mL, the sAA activity revealed moderate sensitivity and specificity as an independent predictor of AMI (78.8% and 74.5%). CONCLUSIONS: High initial sAA activity is an independent predictor of AMI in patients presenting to the ED with chest pain.
BACKGROUND: To rule out acute myocardial infarction (AMI) in chest painpatients constitutes a diagnostic challenge to emergency department (ED) physicians. STUDY OBJECTIVES: To evaluate the diagnostic value of measuring salivary alpha-amylase (sAA) activity for detecting AMI in patients presenting to the ED with acute chest pain. METHODS:sAA activity was measured in a prospective cohort of 473 consecutive adult patients within 4 h of onset of chest pain. Comparisons were made between patients with a final diagnosis of AMI and those with non-AMI. Univariate analysis and multiple logistic regression model were used to identify independent clinical predictors of AMI. RESULTS: Initial sAA activity in the AMI group (n = 85; 266 ± 127.6 U/mL) was significantly higher than in the non-AMI group (n = 388; 130 ± 92.8 U/mL, p < 0.001). sAA activity levels were also significantly higher in patients with ST elevation AMI (n = 53) compared to in those with non-ST elevation AMI (n = 32) (300 ± 141.1 vs. 210 ± 74.1 U/mL, p < 0.001). The area under the receiver operating characteristic curve of sAA activity for predicting AMI in patients with acute chest pain was 0.826 (95% confidence interval [CI] 0.782-0.869), with diagnostic odds ratio 10.87 (95% CI 6.16-19.18). With a best cutoff value of 197.7 U/mL, the sAA activity revealed moderate sensitivity and specificity as an independent predictor of AMI (78.8% and 74.5%). CONCLUSIONS: High initial sAA activity is an independent predictor of AMI in patients presenting to the ED with chest pain.
Authors: Karolina Elżbieta Kaczor-Urbanowicz; Carmen Martin Carreras-Presas; Katri Aro; Michael Tu; Franklin Garcia-Godoy; David Tw Wong Journal: Exp Biol Med (Maywood) Date: 2016-12-08
Authors: C S Miller; J D Foley; P N Floriano; N Christodoulides; J L Ebersole; C L Campbell; A L Bailey; B G Rose; D F Kinane; M J Novak; J T McDevitt; X Ding; R J Kryscio Journal: J Dent Res Date: 2014-05-30 Impact factor: 6.116
Authors: Mohd Aizat Abdul Rahim; Zubaidah Haji Abdul Rahim; Wan Azman Wan Ahmad; Onn Haji Hashim Journal: Int J Med Sci Date: 2015-04-03 Impact factor: 3.738