Rapid serial enzyme measurements in evaluation of patients with suspected myocardial infarction
Because clinical and laboratory criteria cannot accurately establish the presence or absence of acute myocardial infarction (AMI) at the time of initial presentation, this diagnosis is not confirmed in the majority of patients admitted to coronary care units. To study the effectiveness of serial cha...
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| Veröffentlicht in: | The American journal of cardiology 1989-03, Vol.63 (11), p.652-655 |
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| container_end_page | 655 |
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| container_issue | 11 |
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| container_title | The American journal of cardiology |
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| creator | Dufour, D.Robert LaGrenade, Alana Guerra, Julio |
| description | Because clinical and laboratory criteria cannot accurately establish the presence or absence of acute myocardial infarction (AMI) at the time of initial presentation, this diagnosis is not confirmed in the majority of patients admitted to coronary care units. To study the effectiveness of serial changes in enzyme activity in specimens taken at presentation and 8 hours later in establishing the likelihood of AMI, the results in 1,214 patients with acute cardiac symptoms of |
| doi_str_mv | 10.1016/0002-9149(89)90245-2 |
| format | Article |
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To study the effectiveness of serial changes in enzyme activity in specimens taken at presentation and 8 hours later in establishing the likelihood of AMI, the results in 1,214 patients with acute cardiac symptoms of <24 hours' duration were retrospectively evaluated. In 1,007 patients with initially normal creatine kinase (CK), an increase in CK (positive Δ-CK) occurred in 98% of patients with AMI and 16% of patients without AMI. In 196 patients with elevated total CK, a low ratio of CK to aspartate aminotransferase was found in 98% of patients with AMI and 33% of patients without AMI. These 2 enzyme ratios had a sensitivity >90% in patients with typical and atypical histories. The overall predictive value of serial enzyme measurements for AMI was 53%, compared with 18% in patients selected for admission. These results suggest that serial enzyme measurements could be used in the initial evaluation of patients with suspected AMI, and have the potential to reduce the number of patients admitted to coronary care units who do not have AMI.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/0002-9149(89)90245-2</identifier><identifier>PMID: 2923056</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aspartate Aminotransferases - blood ; Biological and medical sciences ; Cardiology. 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To study the effectiveness of serial changes in enzyme activity in specimens taken at presentation and 8 hours later in establishing the likelihood of AMI, the results in 1,214 patients with acute cardiac symptoms of <24 hours' duration were retrospectively evaluated. In 1,007 patients with initially normal creatine kinase (CK), an increase in CK (positive Δ-CK) occurred in 98% of patients with AMI and 16% of patients without AMI. In 196 patients with elevated total CK, a low ratio of CK to aspartate aminotransferase was found in 98% of patients with AMI and 33% of patients without AMI. These 2 enzyme ratios had a sensitivity >90% in patients with typical and atypical histories. The overall predictive value of serial enzyme measurements for AMI was 53%, compared with 18% in patients selected for admission. These results suggest that serial enzyme measurements could be used in the initial evaluation of patients with suspected AMI, and have the potential to reduce the number of patients admitted to coronary care units who do not have AMI.</description><subject>Aspartate Aminotransferases - blood</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Clinical Enzyme Tests - methods</subject><subject>Coronary Care Units</subject><subject>Coronary heart disease</subject><subject>Creatine Kinase - blood</subject><subject>Diagnostic Tests, Routine</subject><subject>Heart</subject><subject>Humans</subject><subject>Isoenzymes</subject><subject>Medical sciences</subject><subject>Myocardial Infarction - diagnosis</subject><subject>Retrospective Studies</subject><subject>Time Factors</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1989</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtKxDAUhoMo43h5A4UsRHRRTdJbshFk8AYDgug6pOkJRnozaUfGpzedKbN0lYT_-08OH0JnlNxQQrNbQgiLBE3EFRfXgrAkjdgemlOei4gKGu-j-Q45REfef4UnpWk2QzMmWEzSbI7km-psiT04qyoMze-6BlyD8oODGpreY9tgWKlqUL1tG9wa3IXbJvmx_Sf2g-9A91Diet1q5cpxjm2McnosnKADoyoPp9N5jD4eH94Xz9Hy9ellcb-MdMyzPiqoMYyQrMiSgpYiNinhFMqwY5oXSghTEKHAZJwliWAsNzpmacKMUJRwRkR8jC63czvXfg_ge1lbr6GqVAPt4GXOBaFpygOYbEHtWu8dGNk5Wyu3lpTI0ascpclRmuRCbrxKFmrn0_yhqKHclSaRIb-YcuW1qoxTjbZ-h-Xh7zjPA3a3xSC4WFlw0usgU0NpXbAoy9b-v8cfHlKUlA</recordid><startdate>19890315</startdate><enddate>19890315</enddate><creator>Dufour, D.Robert</creator><creator>LaGrenade, Alana</creator><creator>Guerra, Julio</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19890315</creationdate><title>Rapid serial enzyme measurements in evaluation of patients with suspected myocardial infarction</title><author>Dufour, D.Robert ; LaGrenade, Alana ; Guerra, Julio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-b1ff2006b64b1d93f5081ed30557ba99fb09aef682449227fc32542f9a1082093</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1989</creationdate><topic>Aspartate Aminotransferases - blood</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Clinical Enzyme Tests - methods</topic><topic>Coronary Care Units</topic><topic>Coronary heart disease</topic><topic>Creatine Kinase - blood</topic><topic>Diagnostic Tests, Routine</topic><topic>Heart</topic><topic>Humans</topic><topic>Isoenzymes</topic><topic>Medical sciences</topic><topic>Myocardial Infarction - diagnosis</topic><topic>Retrospective Studies</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Dufour, D.Robert</creatorcontrib><creatorcontrib>LaGrenade, Alana</creatorcontrib><creatorcontrib>Guerra, Julio</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dufour, D.Robert</au><au>LaGrenade, Alana</au><au>Guerra, Julio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rapid serial enzyme measurements in evaluation of patients with suspected myocardial infarction</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>1989-03-15</date><risdate>1989</risdate><volume>63</volume><issue>11</issue><spage>652</spage><epage>655</epage><pages>652-655</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Because clinical and laboratory criteria cannot accurately establish the presence or absence of acute myocardial infarction (AMI) at the time of initial presentation, this diagnosis is not confirmed in the majority of patients admitted to coronary care units. To study the effectiveness of serial changes in enzyme activity in specimens taken at presentation and 8 hours later in establishing the likelihood of AMI, the results in 1,214 patients with acute cardiac symptoms of <24 hours' duration were retrospectively evaluated. In 1,007 patients with initially normal creatine kinase (CK), an increase in CK (positive Δ-CK) occurred in 98% of patients with AMI and 16% of patients without AMI. In 196 patients with elevated total CK, a low ratio of CK to aspartate aminotransferase was found in 98% of patients with AMI and 33% of patients without AMI. These 2 enzyme ratios had a sensitivity >90% in patients with typical and atypical histories. The overall predictive value of serial enzyme measurements for AMI was 53%, compared with 18% in patients selected for admission. These results suggest that serial enzyme measurements could be used in the initial evaluation of patients with suspected AMI, and have the potential to reduce the number of patients admitted to coronary care units who do not have AMI.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>2923056</pmid><doi>10.1016/0002-9149(89)90245-2</doi><tpages>4</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | The American journal of cardiology, 1989-03, Vol.63 (11), p.652-655 |
| issn | 0002-9149 1879-1913 |
| language | eng |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Aspartate Aminotransferases - blood Biological and medical sciences Cardiology. Vascular system Clinical Enzyme Tests - methods Coronary Care Units Coronary heart disease Creatine Kinase - blood Diagnostic Tests, Routine Heart Humans Isoenzymes Medical sciences Myocardial Infarction - diagnosis Retrospective Studies Time Factors |
| title | Rapid serial enzyme measurements in evaluation of patients with suspected myocardial infarction |
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