Myocardial markers of injury: Evolution and insights

American Journal of Clinical Pathology

Volumn 105, Issue 3, 1996, Pages 305-320

  Keffer, Joseph H ^a  

^a UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER   (United States)

Author keywords

AMI; Cardiac profile; CKMB; Troponin

Indexed keywords

BIOCHEMICAL MARKER; BIOLOGICAL MARKER; CREATINE KINASE MB; MYOGLOBIN; TROPONIN I; TROPONIN T;

CLINICAL EXAMINATION; ELECTROCARDIOGRAM; HEART MUSCLE INJURY; HUMAN; ISCHEMIC HEART DISEASE; PRIORITY JOURNAL; Q WAVE; REFERENCE VALUE; REVIEW;

EID: 0029963917     PISSN: 00029173     EISSN: None     Source Type: Journal    
DOI: 10.1093/ajcp/105.3.305     Document Type: Review

References (221)

1. American Heart Association. Coronary Heart Disease and Angina Pectoris. Heart and Stroke Facts: 1995 Statistical Supplement, Dallas, TX: American Heart Association, 1995.
2. Gunby P. Two new reports help put nation's no. 1 killer disease challenges into perspective for 1993. JAMA 1993;327:449-450.
3. Turi ZG, Rutherford JD, Roberts R, et al. Electrocardiographic, enzymatic and scintigraphic criteria of acute myocardial infarction as determined from study of 726 patients: A MILIS study. Am J Cardiol 1985;55:1463-1468.
4. Ellis AK. Serum protein measurements and the diagnosis of acute myocardial infarction. Circulation 1991;83:1107-1109.
5. Bernard R, Corday E, Eliasch H, et al. Nomenclature and criteria for diagnosis of ischemic heart disease. Report of the joint international society and federation of cardiology/World Health Organization task force on standardization of clinical nomenclature. Circulation 1979;59:607-609.
6. Schroeder JS, Lamb IH, Hu M. Do patients in whom myocardial infarction has been ruled out have a better prognosis after hospitalization than those surviving infarction? N Engl J Med 1980;303:1-5.
7. Rowley JM, Hampton JR. Diagnostic criteria for myocardial infarction. Br J Hosp Med 1981;26:253-256.
8. Katus HA, Remppis A, Neumann FJ, et al. Diagnostic efficiency of troponin T measurements in acute myocardial infarction. Circulation 1991;83:902-912.
9. Hamm CW, Ravkilde J, Gerhardt W, et al. The prognostic value of serum troponin T in unstable angina. N Engl J Med 1992;327:146-150.
10. Eagle KA. Ruling out myocardial infarction [Letter]. N Engl J Med 1991;325:1249-1250.
11. Braunwald E. Mark DB, Jones RH, et al. Unstable angina: Diagnosis and management. Clinical Practice Guideline Number 10. AHCPR Publication No. 94-0602. Rockville, MD: Agency for Health Care Policy and Research and the National Heart, Lung, and Blood Institute, Public Health Service, U.S. Department of Health and Human Services, March 1994.
12. Calvin JE, Klein LW, VandenBerg BJ, et al. Risk stratification in unstable angina: Prospective validation of the Braunwald classification. JAMA 1995;273:136-141.
13. Pettersson T, Ohlsson O, Tryding N. Increased CK MB (mass concentration) in patients without traditional evidence of acute myocardial infarction: A risk indicator of coronary death. Eur Heart J 1992;13:1387-1392.
14. Gibler WB, Lewis LM, Erb RE, et al. Early detection of acute myocardial infarction in patients presenting with chest pain and nondiagnostic ECGs: Serial CK-MB sampling in the emergency department. Ann Emerg Med 1990;19:1359-1366.
15. Rusnak RA, Stair TO, Hansen K, et al. Litigation against emergency physician: Common features in cases of missed myocardial infarction. Ann Emerg Med 1989;18:1029-1034.
16. Lee TH. Chest pain in the emergency department: Uncertainty and the test of time. Mayo Clin Proc 1991;66:963-965.
17. Lee TH, Rouan GW, Weisberg MC, et al. Clinical characteristics and natural history of patients with acute myocardial infarction sent home from the emergency room. Am J Cardiol 1987;60: 219-224.
18. Zarling EJ, Sexton H, Milnor P. Failure to diagnose acute myocardial infarction. JAMA 1983;250:1177-1181.
19. Thompson WG, Mahr RG, Yohannan WS, Pincus MR. Use of creatine kinase MB isoenzyme for diagnosing myocardial infarction when total creatine kinase activity is high. Clin Chem 1988;34:2208-2210.
20. Unrecognized myocardial infarction [Editorial]. Lancet 1984;2: 1379.
21. Kannel WB, Abbott RD. Incidence and prognosis of unrecognized myocardial infarction. N Engl J Med 1984;311:1144-1147.
22. Kannel WB. Prevalence and clinical aspects of unrecognized myocardial infarction and sudden unexpected death. Circulation 1987;75(supplII):4-5.
23. Myerburg RJ, Kessler KM, Mallon SM, et al. Life-threatening ventricular arrhythmias in patients with silent myocardial ischemia due to coronary artery spasm. N Engl J Med 1992;326: 1451-1455.
24. Presentation of myocardial infarction in the elderly [Editorial]. Lancet 1986;2:1077-1078.
25. Sinclair D. Myocardial infarction: Considerations for geriatric patients. Can Fam Physician 1994;40:1172-1177.
26. Limacher M. Clinical features of coronary heart disease in the elderly. Cardiovasc Clin 1992;22:63-73.
27. Tofler GH, Muller JE, Stone PH, et al. Factors leading to shorter survival after acute myocardial infarction in patients ages 65 to 75 years compared with younger patients. Am J Cardiol 1988;62:860-867.
28. Rodstein M. The characteristics of non-fatal myocardial infarction in the aged. Arch Intern Med 1956;98:84-90.
29. McQueen MJ, Holder D, El-Maraghi NRH. Assessment of the accuracy of serial electrocardiograms in the diagnosis of myocardial infarction. Am Heart J 1983;105:258-261.
30. Rouan GW, Lee TH, Cook EF, et al. Clinical characteristics and outcome of acute myocardial infarction in patients with initially normal or nonspecific electrocardiograms: A report from the multicenter chest pain study. Am J Cardiol 1989;64:1087-1092.
31. Taussig AS, Schlant RC. Misleading ECGs: Patterns of psuedoinfarction. J Cardiovasc Med 1983;November:1147-1151.
32. Jayes RL, Larsen GC, Beshansky JR, D'Agostino RB, Selker HP. Physician electrocardiogram reading in the emergency department-accuracy and effect on triage decisions: Findings from a multicenter study. J Gen Intern Med 1992;7:387-392.
33. Califf RM, Ohman EM. The diagnosis of acute myocardial infarction. Chest 1992;101:106S-115S.
34. Lee HS, Cross SJ, Rawles JM, Jennings KP. Patients with suspected myocardial infarction who present with ST depression. Lancet 1993;342:1204-1207.
35. Spodick DH. Q-wave vs non-Q-wave infarction: An oversimplified dichotomy. JAMA 1993;269:590.
36. Moss AJ. Q-wave vs. non-Q-wave myocardial infarction: An oversimplified dichotomy. JAMA 1992;268:1595-1596.
37. Nixon JV. Non-Q-wave myocardial infarction: An incomplete cardiac event requiring an aggressive approach. Postgrad Med 1994;95:211-223.
38. Pirolo JS, Moore GW, Hutchins GM. Continuum of the thickness of surviving myocardial wall with single myocardial infarcts. Arch Pathol Lab Med 1986;110:382-384.
39. DeWood MA, Stifter WF, Simpson CS, et al. Coronary arteriographic findings soon after non-Q-wave myocardial infarction. N Engl J Med 1986;315:417-423.
40. Schwanz JG, Brown RW, McMahan CA, Gage CL, Herber SA. Clinical and analytical evaluation of different methods for measurement of creatine kinase isoenzyme MB. Clin Chem 1989;35:130-134.
41. Chapelle JP, El Allaf M. Automated quantification of creatine kinase MB isoenzyme serum by radial partition immunoassay with use of the Stratus analyzer. Clin Chem 1990;36:99-101.
42. Wu AHB, Gornet TG, Harker CC, Chen HL. Role of rapid immunoassays for urgent ("stat") determinations of creatine kinase isoenzyme MB. Clin Chem 1989;35:1752-1756.
43. Brandt DR, Gates RC, Eng KK, et al. Quantifying the MB isoenzyme of creatine kinase with the Abbott "IMx" immunoassay analyzer. Clin Chem 1990;36:375-378.
44. Henderson AR, Stark JA, McQueen MJ, et al. Is determination of creatine kinase-2 after electrophoretic separation accurate? Clin Chem 1994;40:177-183.
45. Lott JA, Stang JM. Serum enzymes and isoenzymes in the diagnosis and differential diagnosis of myocardial ischemia and necrosis. Clin Chem 1980;26:1241-1250.
46. Hindmarsh JT, Greenway DC, Cheung P, et al. Creatine kinase isoenzyme band mimicking CK MB on agarose gel electrophoresis. Am J Clin Pathol 1991;95:753-756.
47. Medeiros LJ, Greco FA, Walsh D, Gereon B. Macro creatine kinase type 1 with electrophoretic mobility identical to that of the MB isoenzyme. Clin Chem 1985;31:1393-1396.
48. 2 conjugate and polyclonal IgG. Clin Chem 1992;38:1737-1742.
49. Mair J, Artner-Dworzak E, Diensti A, et al. Early detection of acute myocardial infarction by measurement of mass concentration of creatine kinase-MB. Am J Cardiol 1991;68:1545-1550.
50. Gerhardt W, Ljungdahl L. Rational diagnostic strategy in diagnosis of ischemic myocardial injury: S-troponin T and S-CK MB (mass) time series using individual baseline values. Scand J Clin Lab Invest 1993;53(suppl215):47-59.
51. Botker HE, Ravkilde J, Sogaard P, et al. Gradation of unstable angina based on a sensitive immunoassay for serum creatine kinase MB. Br Heart J 1991;65:72-76.
52. Mair J, Morandell D, Genser N et al. Equivalent early sensitivities of myoglobin, creatine kinase MB mass, creatine kinase isoform ratios, and cardiac troponins 1 and T for acute myocardial infarction. Clin Chem 1995;41:1266-1272.
53. Ravkilde J, Hansen AB, Horder M, Jorgensen PJ, Thygesen K. Risk stratification in suspected acute myocardial infarction based on a sensitive immunoassay for serum creatine kinase isoenzyme MB. Cardiology 1992;80:143-151.
54. Ravkilde J, Nissen H, Horder M, Thygesen K. Independent prognostic value of serum creatine kinase isoenzyme MB mass, cardiac troponin T, and myosin light chain levels in suspected acute myocardial infarction. J Am Coll Cardiol 1995;25:574-581.
55. Bakker AJ, Koelemay JW, Corgels JPMC, et al. Troponin T and myoglobin at admission: Value of early diagnosis of acute myocardial infarction. Eur Heart J 1994;15:45-53.
56. Barksy AJ, Hochstrasser B, Coles A, et al. Silent myocardial ischemia: Is the person or the event silent? JAMA 1990;264:1132-1135.
57. Tunstall Pedoe H, Clayton D, Morris JN, Brigden W, McDonald L. Coronary heart-attacks in East London. Lancet 1975;November:833-838.
58. Gerhardt W, Katus H, Ravkilde J, et al. S-troponin T in suspected ischemic myocardial injury compared with mass and catalytic concentrations of s-creatine kinase isoenzyme MB. Clin Chem 1991;37:1405-1411.
59. Wu AHB, Valdes R, Apple FS, et al. Cardiac troponin-T immunoassay for diagnosis of acute myocardial infarction. Clin Chem 1994;40:900-907.
60. Collinson PO, Ramhamadamy EM, Rosalki SB, et al. Diagnosis of acute myocardial infarction from sequential enzyme measurements obtained within 12 hours of admission to hospital. J Clin Pathol 1989;42:1126-1131.
61. Collinson PO, Ramhamadamy EM, Greenwood TW, Rosalki SB. Ruling out myocardial infarction. N Engl J Med 1991;325: 1249.
62. Collinson PO, Chandler HA, Ball SG, Ramhamadamy EM. A predictive system for rapid confirmation or exclusion of acute myocardial infarction. Applied Cardiopulmonary Pathophysiology 1992;4:225-228.
63. Collinson PO, Rosalki SB, Kuwana T, et al. Early diagnosis of acute myocardial infarction by CK-MB mass measurements. Ann Clin Biochem 1992;29:43-47.
64. Chattington P, Clarke D, Neithercut WD. Timed sequential analysis of creatine kinase in the diagnosis of myocardial infarction in patients over 65 years of age. J Clin Pathol 1994;47:995-998.
65. Chattington P, Clarke D, Neithercut WD. Creatine kinase isoform electrophoresis for the early confirmation of myocardial infarction detected by timed sequential CK slope analysis. Postgrad Med J 1994;70:805-808.
66. Lee TH, Goldman L. Ruling out acute myocardial infarction [Letter]. N Engl J Med 1991;325:1250.
67. Leung FY, Griffith AP, Jablonsky G, Henderson AR. Comparison of the diagnostic utility of timed serial (slope) creatine kinase measurements with conventional serum tests in the early diagnosis of myocardial infarction. Ann Clin Biochem 1991;28:78-82.
68. Vijan SG, Ingle AR, Hill PG, Millar-Craig MW. Failure of creatine kinase slope values to reliably predict acute myocardial infarction. Ann Clin Biochem 1991;28:103-104.
69. Keffer JH, Heesch CM, Slatton ML, Eichhorn EL. Assessment of a gradient of troponin-I and CK-MB across the heart. Clin Chem 1995;41:S237 (Abstr).
70. Galen RS, Reiffel JA, Gambino R. Diagnosis of acute myocardial infarction: Relative efficiency of serum enzyme and isoenzyme measurements. JAMA 1975;232:145-147.
71. Pearson JR, Carrea F. Evaluation of the clinical usefulness of a chemiluminometric method for measuring creatine kinase MB. Clin Chem 1990;36:1809-1811.
72. Adams JE, Ladenson JH, Jaffe AS. Troponin I in the diagnosis of postoperative myocardial infarction [Letter]. N Engl J Med 1994;331:277.
73. Potkin RT, Werner JA, Trobaugh GB, et al. Evaluation of noninvasive tests of cardiac damage in suspected cardiac contusion. Circulation 1982;66:627-631.
74. Gerhardt W. Ljungdahl L, Herbert AK. Troponin-T and CK MB (mass) in early diagnosis of ischemic myocardial injury: The Helsingborg study, 1992. Clin Biochem 1993;26:231-240.
75. Abenschein DR, Fontanet HL, Nohara R. Optimized preservation of isoforms of creatine kinase MM isoenzymes in plasma specimens and their rapid quantification by semi-automated chromatofocusing. Clin Chem 1990;36:723-727.
76. Apple FS, Sharkey SW, Werdick M, Elsperger J, Tilbury RT. Analyses of creatine kinase isoenzymes and isoforms in serum to detect reperfusion after acute myocardial infarction. Clin Chem 1987;33:507-511.
77. Jaffe AS, Eisenberg PR, Abendschein DR. Conjoint use of MM and MB creatine kinase isoforms in detection of coronary recanalization. Am Heart J 1994;127:1461-1466.
78. Wu AHB, Wang XM, Gornet TG, Ordonez-Llanos J. Creatine kinase MB isoforms in patients with skeletal muscle injury: Ramifications for early detection of acute myocardial infarction. Clin Chem 1992;38:2396-2400.
79. Bhayana V, Cohoe S, Leung FY, Jablonsky G, Henderson AR. Diagnostic evaluation of creatine kinase-2 mass and creatine kinase-3 and -2 isoform ratios in early diagnosis of acute myocardial infarction. Clin Chem 1993;39:488-495.
80. Puleo RP, Guadagno PA, Roberts R, Perryman MB. Sensitive, rapid assay of subforms of creatine kinase MB in plasma. Clin Chem 1989;35:1452-1455.
81. Puleo RP, Meyer D, Wathen C, et al. Use of a rapid assay of subforms of creatine kinase MB to diagnose or rule out acute myocardial infarction. N Engl J Med 1994;331:561-566.
82. Keffer JH. Subforms of creatine kinase MB in the diagnosis of myocardial infarction [Letter]. N Engl J Med 1995;332:608.
83. Roberts R, Puleo P. Subforms of creatine kinase MB in the diagnosis of myocardial infarction [Reply]. N Engl J Med 1995;332: 609-610.
84. Puleo RP, Perryman MB, Bohlmeyer TJ, Roberts R. Comparison of an MBCK immunoenzymetric assay to the batch adsorption procedure in a CCU population. Clin Chem 1985;31:991 (Abstr).
85. Lee TH, Juarez G, Cook EF, et al. Ruling out myocardial infarction: A prospective multicenter validation of a 12-hour strategy for patients at low risk. N Engl J Med 1991;324:1239-1246.
86. Gibier WB, Runyon JP, Levy RC, et al. A rapid diagnostic and treatment center for patients with chest pain in the emergency department. Ann Emerg Med 1995;25:1-8.
87. Bokhari AM, Davies J, Davies J, et al. Biochemical diagnosis of myocardial infarction within the thrombolytic time window, Int J Cardiol 1995;48:249-254.
88. Uji Y, Kamen A, Sugiuchi H, et al. Simultaneous automated measurement of serum total CK and CK-MM isoform ratio in serum. J Clin Anal 1994;8:273-276.
89. Ohman EM, Casey C, Bengtson JR, et al. Early detection of acute myocardial infarction: Additional diagnostic information from serum concentrations of myoglobin in patients without ST elevation. Br Heart J 1990;3:335-338.
90. Brogan GX, Friedman S, McCuskey C, et al. Evaluation of a new rapid quantitative immunoassay for serum myoglobin versus CK-MB for ruling out acute myocardial infarction in the emergency department. Ann Emerg Med 1994;24:665-671.
91. Tucker JF, Collins RA, Anderson AJ, et al. Value of serial myoglobin levels in the early diagnosis of patients admitted for acute myocardial infarction. Ann Emerg Med 1994;24:704-708.
92. Woo J, Lacbawan FL, Sunheimer R, et al. Is myoglobin useful in the diagnosis of acute myocardial infarction in the emergency department setting? Am J Clin Pathol 1995;103:725-729.
93. Vuori J, Rasi S, Takala T, Vaananen K. Dual-label time resolved fluoroimmunoassay for simultaneous detection of myoglobin and carbonic anhydrase III in serum. Clin Chem 1991;37:2087-2092.
94. Miyata M, Abe S, Arima S, et al. Rapid diagnosis of coronary reperfusion by measurement of myoglobin level every 15 min-utes in acute myocardial infarction. J Am Coll Cardiol 1994;23: 1009-1015.
95. Yamashita T, Abe A, Arima S, et al. Myocardial infarct size can be estimated from serial plasma myoglobin measurements within 4 hours of reperfusion. Circulation 1993;87:1840-1849.
96. Katus HA, Scheffold T, Remppis A, Zehleim J. Proteins of the troponin complex. Lab Med 1992;23:311-317.
97. Troponin T and myocardial damage [Editorial]. Lancet 1991;338:23-24.
98. Mair J, Artner-Dworzak E, Lechleitner P, et al. Cardiac troponin T in diagnosis of acute myocardial infarction. Clin Chem 1991;37:845-852.
99. Mair J, Dienstl F, Puschendorf B. Cardiac troponin T in the diagnosis of myocardial injury. Crit Rev Clin Lab Sci 1992;29:31-57.
100. Collinson PO, Moseley D, Stubbs PJ, Carter GD. Troponin T for the differential diagnosis is ischaemic myocardial damage. Ann Clin Biochem 1993;30:11-16.
101. Ravkilde J, Nissen H, Mickley H, et al. Cardiac troponin T and CK-MB mass release after visually successful percutaneous transluminal coronary angioplasty in stable angina pectoris. Am Heart J 1994;127:13-20.
102. Panteghini M, Pagani F. Diagnostic value of a single measurement of troponin T in serum for suspected acute myocardial infarction [Letter]. Clin Chem 1994;40:673-674.
103. Wu AH. Cardiac troponin T: Biochemical, analytical, and clinical aspects. J Clin Immunoassay 1994;17:45-48.
104. Wu AHB, Valdes R, Apple FS, et al. Cardiac troponin-T immunoassay for diagnosis of acute myocardial infarction. Clin Chem 1994;40:900-907.
105. Katus HA, Looser S, Hallermayer K, et al. Development and in vitro characterization of a new immunoassay of cardiac troponin T. Clin Chem 1992;38:386-392.
106. Sabry MA, Dhoot GK. Identification of a pattern of transitions of cardiac, adult slow, and slow skeletal muscle-like embryonic isoforms of troponin T in developing rat and human skeletal muscles. J Muscle Res Cell Motil 1991;12:262-270.
107. Anderson PAW, Malouf NN, Oakeley AE, Pagani ED, Allen PD. Troponin T isoform expression in humans: A comparison among normal and failing adult heart, fetal heart, and adult and fetal skeletal muscle. Circ Res 1991;69:1226-1233.
108. Saggin L, Gorza L, Ausoni S, Schiaffino S. Cardiac troponin T in developing, regenerating and denervated rat skeletal muscle. Development 1990;110:547-554.
109. Anderson PAW, Malouf NN, Oakeley AE, Pagani ED, Allen PD. Troponin T isoform expression in the normal and failing human left ventricle: A correlation with myofibrillar A TPase activity. Basic Res Cardiol 1993;88:117-127.
110. Kobayashi S, Tanaka M, Tamura N, et al. Serum cardiac troponin T in polymysitis/dermatomyositis [Letter]. Lancet 1990;340:726.
111. Bodor GS, Porterfield D, Voss E, et al. Cardiac troponin T composition in normal and regenerating human skeletal muscle. Clin Chem 1995;41:8148 (Abstr).
112. Bhayana V,Gougoulias T, Cohoe S, Henderson AR. Discordance between results for serum troponin T and troponin I in renal disease. Clin Chem 1995;41:312-317.
113. Hafner G, Thome-Kromer B, Schaube J, et al. Cardiac troponins in serum in chronic renal failure. Clin Chem 1994;40:1790-1791.
114. Li D, Keffer J, Corry K, Vazquez M, Jialal I. Nonspecific elevation of troponin T levels in patients with chronic renal failure. Clin Biochem 1995;28:474-477.
115. Weisensee D, Low-Friedrich I, Riehle M, Bereiter-Hahn J, Schoeppe W. In vitro approach to "uremic cardiomyopathy." Nephron 1993;65:392-400.
116. Okouchi Y, Arisaka H, Shimada A, et al. Improvement of left ventricular function after renal transplantation in a patient with uremic cardiomyopathy: report of a case. Surg Today 1993;23: 998-1002.
117. Gerhardt W, Katus HA, Ravkilde J, Hamm CW. S-troponin-T as a marker of ischemic myocardial injury [Letter]. Clin Chem 1992;38:1194-1195.
118. Jaffe AS. In search of specificity: The troponins. ACC Cur J Rev 1995;5:29-33.
119. Bodor GS, Porter S, Landt Y, Ladenson JH. Development of monoclonal antibodies for an assay of cardiac troponin-l and preliminary results in suspected cases of myocardial infarction. Clin Chem 1992;38:2203-2214.
120. Cummins B, Cummins P. Cardiac specific troponin-I release in canine experimental myocardial infarction: Development of a sensitive enzyme-linked immunoassay. J Mol Cell Cardiol 1987;19:999-1010.
121. Cummins P, Young A, Auckland ML, Michie AC, Stone PCW. Comparison of serum cardiac specific troponin-I with creatine kinase, creatine kinase-MB isoenzyme, tropomyosin, myoglobin and C-reactive protein release in marathon runners: Cardiac or skeletal muscle trauma? Eur J Clin Invest 1987;17:317-324.
122. Adams JE, Bodor GS, Davila-Romain V, et al. Cardiac troponin I. A marker with high specificity for cardiac injury. Circulation 1993;88:101-106.
123. Mair J, Larue C, Mair P, et al. Use of cardiac troponin I to diagnose perioperative myocardial infarction in coronary artery bypass grafting. Clin Chem 1994;40:2066-2070.
124. Adams JE, Sicard GA, Allen BT, et al. Diagnosis of perioperative myocardial infarction with measurement of cardiac troponin I. N Engl J Med 1994;330:670-674.
125. Adams JE, Schechtman KB, Landt Y, Ladenson JH, Jaffe AS. Comparable detection of acute myocardial infarction by creatine kinase MB isoenzyme and cardiac troponin I. Clin Chem 1994;40:1291-1295.
126. Bertinchant JP, Larue C, Mair J, et al. Cardiac troponin I to diagnose myocardial injury. Clin Chem 1994;40:995 (Abstr).
127. Guest TM, Ramanathan AV, Tuteur PG, et al. Myocardial injury in critically ill patients: A frequently unrecognized complication. JAMA 1995;273:1945-1949.
128. Collinson PO, Moseley D, Stubbs PJ, Carter GD. Troponin T for the differential diagnosis of ischaemic myocardial damage. Ann Clin Biochem 1993;30:11-16.
129. Frazee RC, Mucha P, Farnell MB, Miller FA. Objective evaluation of blunt cardiac trauma. J Trauma 1986;26:510-520.
130. Traumatic injury of the heart [Editorial]. Lancet 1990;336:1287-1289.
131. Mair J, Genser N, Puschendorf B, et al. Sensitive and specific diagnosis of acute myocardial infarction by a rapid immunoenzymometric assay of cardiac troponin I. Clin Chem 1994;40: 998 (Abstr).
132. Mair J, Wagner I, Puschendorf B, et al. Cardiac troponin I to diagnosemyocardial injury. Lancet 1993;341:838-839.
133. Jaffe AS, Garfinkel BT, Ritter CS, Sobel BE. Plasma MB creatine kinase after vigorous exercise in professional athletes. Am J Cardiol 1984;53:856-858.
134. Ordonez-Llanos J, Serra-Grima JR, Merce-Muntanola J, Gonzalez-Sastre F. Ratio of creatine kinase 2 mass concentration to total creatine kinase activity not altered by heavy physical exercise. Clin Chem 1992;38:2224-2227.
135. Salvadori A, Fanari P, Ruga S, Brunani A, Longhini E. Creatine kinase and creatine kinase-MB isoenzyme during and after exercise testing in normal and obese young people. Chest 1992;102:1687-1689.
136. Goldman L. Assessment of perioperative cardiac risk. N Engl J Med 1994;330:707-709.
137. Ashton CM. Perioperative myocardial infarction with noncardiac surgery. Am J Med Sci 1994;308:41-48.
138. Mangano DT, Hollenberg M, Fegert G, et al. Perioperative myocardial ischemia in patients undergoing noncardiac surgery-I: Incidence and severity during the 4 day perioperative period. J Am Coll Cardiol 1991;17:843-850.
139. Mangano DT, Browner WS, Hollenberg M, et al. Association of perioperative myocardial ischemia with cardiac morbidity and mortality in men undergoing noncardiac surgery. N Engl J Med 1990;323:1781-1788.
140. Mair P, Mair J, Seibt I, etal. Creatine kinase isoenzyme MB mass concentrations in patients undergoing aortocoronary bypass surgery, Clin Chim Acta 1994;224:203-207.
141. Tabatabai M, Segal R, Amidi M, et al. Serum creatine phosphokinase, lactic dehydrogenase, and their isoenzymes in the perioperative period. J Clin. Anesth 1989;1:277-283.
142. Tabatabai M, Segal R, Amidi M, et al. Changes in serum CPK, LDH, and their isoenzymes in the perioperative period in patients undergoing craniotomy. J Neurosurg Anesthesiol 1990;2: 266-271.
143. Perioperative myocardial ischaemia and noncardiac surgery [Editorial]. Lancet 1991;337:1516-1517.
144. Katus HA, Schoeppenthau M, Tanzeem A, et al. Noninvasive assessment of perioperative myocardial cell damage by circulating cardiac troponin T. Br Heart J 1991;65:259-264.
145. Olthof H, Middelhof C, Meijne NG, et al. The definition of myocardial infarction during aortocoronary bypass surgery. Am Heart J 1983;106:631-637.
146. Mair P, Mair J, Seibt I, et al. Creatine kinase isoenzyme MB mass concentrations in patients undergoing aortocoronary bypass surgery. Clin Chim Acta 1994;224:203-207.
147. Oldham HN, Roe CR, Young WG, Dixon SH. Intraoperative detection of myocardial damage during coronary artery surgery by plasma creatine phosphokinase isoenzyme analysis. Surgery 1973;74:917-925.
148. Willems GM, van der Veen FH, Huysmans HA, et al. Enzymatic assessment of myocardial necrosis after cardiac surgery: Differentiation from skeletal muscle damage, hemolysis, and liver injury. Am Heart J 1985;109:1243-1252.
149. Griesmacher A, Grimm M, Schreiner W, Muller MM. Diagnosis of perioperative myocardial infarction by considering relationship of postoperative electrocardiogram changes and enzyme increases after coronary bypass operation. Clin Chem 1990;36: 883-887.
150. Hannes W, Keilich M, Koster W, Seitelberger R, Fasol R. Shed blood autotransfusion influences ischemia-sensitive laboratory parameters after coronary operations. Ann Thorac Surg 1994;57:1289-1294.
151. Mair P, Mair J, Seibt I, et al. Cardiac troponin T: A new marker of myocardial tissue damage in bypass surgery. J Cardiothorac Vasc Anesth 1993;7:674-8.
152. Eikvar L, Pillgram-Larsen J, Skjaeggestad O, Arnesen H, Stromme JH. Serum cardio-specific troponin T after open heart surgery in patients with and without perioperative myocardial infarction. Scand J Clin Lab Invest 1994;54:329-335.
153. Uchino T, Belboul A, Roberts D, Jagenburg R. Measurement of myosin light chain I and troponin T as markers of myocardial damage after cardiac surgery. J Cardiovasc Surg 1994;35:201-206.
154. Mair J, Larue C, Mair P, et al. Use of cardiac troponin I to diagnose perioperative myocardial infarction in coronary artery bypass grafting. Clin Chem 1994;40:2066-2070.
155. Reeder GS, Kopecky SL. Thrombolysis in acute myocardial infarction: t-PA for everyone? Mayo Clin Proc 1994;69:796-799.
156. Pfeffer MA, Moye LA, Braunwald E, et al. Selection bias in the use of thrombolytic therapy in acute myocardial infarction: The SAVE investigators. JAMA 1991;266:528-532.
157. Doorey AJ, Michelson EL, Topol EJ. Thrombolytic therapy of acute myocardial infarction. JAMA 1992;268:3108-3114.
158. GUSTO Angiographic Investigators. The effects of tissue plasminogen activator, streptokinase. or both on coronary artery patency, ventricular function, and survival after acute myocardial infarction. N Engl J Med 1993;329:1615-1622.
159. Gunn IR, Mir NS, Parnham AJ, et al. Emergency serum creatine kinase MB isoenzyme concentration in patients with suspected acute myocardial infarction. Health Bulletin 1993;51:166-176.
160. Pepine CJ. New markers for early diagnosis of ischemic myocardial injury [Editorial]. J Myocard Ischem 1994;6:8-9.
161. Fibrinolytic Therapy Trialists' (FTT) Collaborative Group. Indications for fibrinolytic therapy in suspected acute myocardial infarction: Collaborative overview of early mortality and major morbidity results from all randomized trials of more than 1.000 patients. Lancet 1994;343:311-322.
162. Ohman EM, Armstrong P, CaliffRM, et al. Risk stratification in acute ischemic syndromes using serum troponin T. J Am Coll Cadiol 1995;25:14A.
163. Norris RM, White HD, Cross DB, et al. Noninvasive diagnosis of arterial patency after thrombolytic treatment and its relation to prognosis. Br Heart J 1993;69:485-491.
164. Ishii J, Monura M, Ando T, et al. Early detection of successful coronary reperfusion based on serum myoglobin concentration: Comparison with serum creatine kinase isoenzyme MB activity. Am Heart J 1994;128:641-648.
165. Abe J, Yamaguichi T, IsshikiT, et al. Myocardial reperfusion can be predicted by myoglobin/creatine kinase ratio of a single blood sample obtained at the time of admission. Am Heart J 1993;126:279-285.
166. Remppis A, Scheffold T, Karrer O, et al. Assessment of reperfusion of the infarct zone after acute myocardial infarction by serial cardiac troponin T measurements in serum. Br Heart J 1994;71:242-248.
167. Klootwijk P, Cobbaert C, Fioretti P, Kint PP, Simoons ML. Noninvasive assessment of reperfusion and reocclusion after thrombolysis in acute myocardial infarction. Am J Cardiol 1993;72: 75G-84G.
168. Califf RM, O'Neill W, Stack RS, et al. Failure of simple clinical measurements to predict perfusion status after intravenous thrombolysis. Ann Intern Med 1988;108:658-662.
169. Ohman EM, Christenson RH, Califf RM, et al. Noninvasive detection of reperfusion after thrombolytic therapy based on serum creatine kinase MB changes and clinical variables. TAMI 7 study group: Thrombolysis and angioplasty in myocardial infarction. Am Heart J 1993;126:819-826.
170. Christenson RH, Clemmensen P, Ohman EM, et al. Relative increase in creatine kinase MB isoenzyme during reperfusion after myocardial infarction is method dependent. Clin Chem 1990;36:1444-1449.
171. Mattioni TA. Long-term prognosis after myocardial infarction: Who is at risk for sudden death? Postgrad Med 1992;92:107-114.
172. Little WC, Constantinescu M, Applegate RJ, et al. Can coronary angiography predict the site of a subsequent myocardial infarction in patients with mild-to-moderate coronary artery disease? Circulation 1988;78:1157-1166.
173. Ambrose JA, Tannenbaum MA, Alexopoulos D, et al. Angiographic progression of coronary artery disease and the development of myocardial infarction. J Am Coll Cardiol 1988;12:56-62.
174. Fowler NO. "Preinfarctional" angina: A need for an objective definition and for a controlled clinical trial of its management. Circulation 1971;44:755-758.
175. Tofler GH, Muller JE, Stone PH, et al. Comparison of long-term outcome after acute myocardial infarction in patients never graduated from high school with that in more education patients. Am J Cardiol 1993;71:1031-1035.
176. Braunwald E. Unstable angina: A classification. Circulation 1989;80:410-414.
177. Abdelmeguid AE, Ellis SG, Sapp SK, et al. Directional coronary atherectomy in unstable angina. J Am Coll Cardiol 1994;24:46-54.
178. Assaf AR, Lapane KL, McKenney JL, Carleton RA. Possible influence of the prospective payment system on the assignment of discharge diagnoses for coronary heart disease. N Engl J Med 1993;329:931-935.
179. Ravkilde J, Horder M, Gerhardt W, et al. Diagnostic performance and prognostic value of serum troponin T in suspected acute myocardial infarction. Scand J Clin Lab Invest 1993;53: 677-685.
180. Armstrong PW, Chiong MA, Parker JO. The spectrum of unstable angina: Prognostic role of serum creatine kinase determination. Am J Cardiol 1982;49:1849-1852.
181. Clyne CA, Medeiros LJ, Marton KL. The prognostic significance of immunoradiometric CK-MB assay (IRMA) diagnosis of myocardial infarction in patients with low total CK and elevated MB isoenzymes. Am Heart J 1989;118:901-906.
182. Murphy JJ, Connell PA, Hamptom JR. Predictors of risk in patients with unstable angina admitted to a district general hospital. Br Heart J 1992;67:395-401.
183. Falk E. Unstable angina with fatal outcome: Dynamic coronary thrombosis leading to infarction and/or sudden death. Circulation 1985;71:699-708.
184. Davies MJ, Thomas AC. Plaque fissuring: The cause of acute myocardial infarction, sudden ischaemic death, and crescendo angina. Br Heart J 1985;53:363-373.
185. Davies MJ, Thomas AC, Knapman PA, Hangartner AR. Intramyocardial platelet aggregation in patients with unstable angina suffering sudden ischemic cardiac death. Circulation 1986;3: 418-427.
186. Sherman CT, Litvack F. Grundfest W, et al. Coronary angioscopy in patients with unstable angina pectoris. N Engl J Med 1986;315:913-919.
187. Mizuno K, Miyamoto A, Satomura K, et al. Angioscopic coronary macromorphology in patients with acute coronary disorders. Lancet 1991;337:809-812.
188. Mizuno K, Satomura K, Miyamoto A, et al. Angioscopic evaluation of coronary artery thrombi in acute coronary syndromes. N Engl J Med 1992;326:287-291.
189. Abdelmeguid AE, Whitlow PL, Sapp SK, et al. Long-term outcome of transient uncomplicated in-laboratory coronary artery closure. Circulation 1995;91:2733-2741.
190. Weisman HF, Healy B. Myocardial infarct expansion, infarct extension, and reinfarction: Pathophysiologic concepts. Prog Cardiovasc Dis 1987;30:73-110.
191. Buda AJ, Macdonald IL, Dubbin JD, Orr SA, Strauss HD. Myocardial infarct extension: Prevalence, clinical significance, and problems in diagnosis. Am Heart J 1983;105:744-749.
192. Liuzzo G, Biasucci LM, Gallimore JR, et al. The prognostic value of c-reactive protein and serum amyloid a protein in severe unstable angina. N Engl J Med 1994;331:417-424.
193. Alexander RW. Inflammatory and coronary artery disease [Editorial]. N Engl J Med 1993;331:468-469.
194. Miyao Y, Yasue H, Ogawa H, et al. Elevated plasma interleukin6 levels in patients with acute myocardial infarction. Am Heart J 1993;126:1299-1304.
195. Cruickshank AM, Oldroyd KG, Cobbe SM. Serum interleukin-6 in suspected myocardial infarction. Lancet 1994;343:974.
196. Van Lente F, Kazmierczak SC. Interleukin-6 as a first-look indicator of acute myocardial infarction. Clin Chem 1995;41:1189-1190.
197. Bain RJI, Fox JP, Jagger J, et al. Serum cortisol levels predict infarct size and patient mortality. Int J Cardiol 1992;37:145-150.
198. Lasala GP, Wright T, Osman K, et al. Plasma oxidase assay for screening of myocardial infarction. Am J Med Sci 1994;308: 157-161.
199. Ohkaru Y, Asayama K, Ishii H, et al. Development of a sandwich enzyme-linked immunosorbent assay for the determination of human heart type fatty acid-binding protein in plasmaand urine by using two different monoclonal antibodies specific for human heart fatty acid-binding protein. J Immunolog Methods 1995;178:99-111.
200. Healy JC, Spackman KA, Beck JR. Small expert systems in clinical pathology. Arch Pathol Lab Med 1989;113:981-983.
201. Furlong JW, Dupuy ME, Heinsimer JA. Neural network analysis of serial cardiac enzyme data: A clinical application of artificial matching intelligence. Clin Chem 1991;96:134-141.
202. Gibier WB. Chest pain evaluation in the ED: Beyond triage [Editorial]. Am J Emerg Med 1994;12:121-122.
203. Gibier WB, Young GP, Hedges JR, et al. Acute myocardial infarction in chest pain patients with nondiagnostic ECGs: Serial CK-MB sampling in the emergency department. Ann Emerg Med 1992;21:504-512.
204. Gibier WB. Evaluating patients with chest pain in the ED: Improving speed, efficiency, and cost-effectiveness, or teaching an old dog new tricks. Ann Intern Med 1994;23:381-382.
205. Goldman L, Weinberg M, Weisberg M, et al. A computer-derived protocol to aid in the diagnosis of emergency room patients with acute chest pain. N Engl J Med 1982;307:588-596.
206. Lee TH, Rouan GW, Weisberg MC, et al. Sensitivity of routine clinical criteria for diagnosing myocardial infarction within 24 hours of hospitalization. Ann Intern Med 1987;106:181-186.
207. Eagle KA. Medical decision making in patients with chest pain [Editorial]. N Engl J Med 1991;324:1282-1283.
208. Lee TH, Ting HH, Shammash JB, Soukup JR, Goldman L. Long-term survival of emergency department patients with acute chest pain. Am J Cardiol 1992;69:145-151.
209. Fesmire FM, Wears RL, Percy RF. In-hospital outcome in patients with coronary artery disease in whom myocardial infarction has been ruled out [Letter]. N Engl J Med 1989;320: 1423-1424.
210. Deedwania PC. Is there evidence in support of the ischemia suppression hypothesis? J. Am Coll Cardiol 1994;24:21-24.
211. Knatterud GL, Bourassa MB, Pepine CJ, et al. Effects of treatment strategies to suppress ischemia in patients with coronary artery disease: 12-week results of the asymptomatic cardiac ischemia pilot (ACIP) study. J Am Coll Cardiol 1994;24:11-20.
212. Pepine CJ, Geller NL, Knatterud GL, et al. The asymptomatic cardiac ischemia pilot (ACIP) study: Design of a randomized clinical trial, baseline data and implications for a long-term outcome trial. J Am Coll Cardiol 1994;24:1-10.
213. Gaspoz JM, Lee TH, Weinstein MC, et al. Cost-effectiveness of a new short-stay unit to "rule out" acute myocardial infarction in low risk patients. J Am Coll Cardiol 1994;24:1249-1259.
214. Kereiakes DJ, Weaver WD, Anderson JL, et al. Time delays in the diagnosis and treatment of acute myocardial infarction: A tale of eight cities. Report from the pre-hospital study group and the Cincinnati heart project. Am Mean J 1990;120:773-780.
215. Bahr RD. The changing paradigm of acute heart attack prevention in the emergency department: A futuristic viewpoint? Ann Emerg Med 1995;25:95-96.
216. National Heart Attack Alert Program Coordinating Committee, 60 minutes to treatment working group. Emergency department: Rapid identification and treatment of patients with acute myocardial infarction. NIH Publication 1993 93-3278. Publisher USDHHS.
217. American College of Emergency Physicians. Clinical policy for the initial approach to adults presenting with a chief complaint of chest pain, with no history of trauma. Ann Emerg Med 1995;25:274-299.
218. Shesser R, Smith M. The chest pain emergency department and the outpatient chest pain evaluation center: Revolution or evolution? Ann Emerg Med 1994;23:334-341.
219. Riesenberg D. Consensus conferences. JAMA 1987;258:2738.
220. Kosecoff J, Kanouse DE, Rogers WH, et al. Effects of the national institutes of health consensus development program on physician practice. JAMA 1987;258:2708-2713.
221. Lewis LM, Lasater LC, Ruoff BE. Failure of a chest pain clinical policy to modify physician evaluation and management. Ann Emerg Med 1995;25:9-14.