Ruling Out Myocardial Infarction with Troponin T and Creatine Kinase MB Mass: Diagnostic and Prognostic Aspects

Author: Koukkunen Heli   Penttilä Karri   Kemppainen Ari   Penttilä Ilkka   Halinen Matti   Rantanen Tapio   Pyörälä Kalevi  

Publisher: Informa Healthcare

ISSN: 1401-7431

Source: Scandinavian Cardiovascular Journal, Vol.35, Iss.5, 2001-10, pp. : 302-306

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Abstract

Objective - To investigate the time window for ruling out myocardial infarction (MI) with troponin T (TnT) and creatine kinase isoenzyme MB mass (CK-MBm) and the prognosis of patients with ruled-out MI diagnosis.Design - The study was based on 397 patients admitted with a suspected acute coronary syndrome but with relief of symptoms within 24 h.Results - MI diagnosis was confirmed with elevated TnT (> 0.10 µg/l) in 108 patients, in 91% within 12-24 h from the onset of symptoms, and in 99% within 12 h from admission. In 94 of these patients CK-MBm became elevated (> 5.0 µg/l), in 95% within 10-12 h from the onset of symptoms, and in 99% within 6 h from admission. Among patients with ruled-out MI diagnosis, the 1-year incidence of recurrent coronary events was 29% in those with positive history of coronary heart disease (CHD) but only 7% in those without prior CHD (p < 0.001).Conclusion - Using TnT or CK-MBm, MI can be ruled out within 12 h from admission in the majority of patients. Among patients with ruled-out MI diagnosis, positive history of CHD is an important determinant of prognosis.

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