A rapid point-of-care cardiac marker testing strategy facilitates the rapid diagnosis and management of chest pain patients in the emergency department

American Journal of Clinical Pathology

Volumn 129, Issue 5, 2008, Pages 788-795

  Straface, Angela L ^a   Myers, John H ^b   Kirchick, Howard J ^c   Blick, Kenneth E ^d,e  

^a Arlington Cancer Center   (United States)

^b Medical City Dallas   (United States)

^c Medical and Scientific Affairs   (United States)

^d Oklahoma University   (United States)

^e University of Oklahoma Medical Center   (United States)

Author keywords

Acute myocardial infarction; Cardiac markers; Point of care testing; Turnaround times

Indexed keywords

BIOLOGICAL MARKER; CARDIAC MARKER; CREATINE KINASE; MYOGLOBIN; TROPONIN I;

ACUTE HEART INFARCTION; ADULT; AGED; ARTICLE; CLINICAL ASSESSMENT; CREATINE KINASE BLOOD LEVEL; DIAGNOSTIC ACCURACY; DIAGNOSTIC TEST; EMERGENCY WARD; FEMALE; HUMAN; LABORATORY TEST; MAJOR CLINICAL STUDY; MALE; POINT OF CARE TESTING; PRIORITY JOURNAL; PROTEIN BLOOD LEVEL; THORAX PAIN; ALGORITHM; BLOOD; CLINICAL TRIAL; COMPARATIVE STUDY; EMERGENCY HEALTH SERVICE; HEART INFARCTION; HOSPITAL INFORMATION SYSTEM; LENGTH OF STAY; METHODOLOGY; MIDDLE AGED; MULTICENTER STUDY; SENSITIVITY AND SPECIFICITY; TREATMENT OUTCOME;

ALGORITHMS; BIOLOGICAL MARKERS; CHEST PAIN; CREATINE KINASE; EMERGENCY MEDICAL SERVICES; FEMALE; HUMANS; LENGTH OF STAY; MALE; MIDDLE AGED; MYOCARDIAL INFARCTION; MYOGLOBIN; POINT-OF-CARE SYSTEMS; SENSITIVITY AND SPECIFICITY; TREATMENT OUTCOME; TROPONIN I;

EID: 44849118236     PISSN: 00029173     EISSN: None     Source Type: Journal    
DOI: 10.1309/9GGNMURLJWJD88W3     Document Type: Article

References (35)

1. Rosamond W, Flegal K, Friday G, et al; for the American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics: 2007 update: a report from the American Heart Association Statistics Committee and Stroke Statistics Subcommittee [published correction appears in Circulation. 2007;115:e172. doi:10.1161/CIRCULATIONAHA.107. 181865]. Circulation. 2007;115:e69-e171. doi:10.1161/ CIRCULATIONAHA.106.179918.
2. National Heart Attack Alert Program. Available at: http:// www.nhlbi.nih.gov/about/nhaap/nhaap_pd.htm. Accessed December 28, 2006.
3. Hlatky MA. Evaluation of chest pain in the emergency department. N Engl J Med. 1997;337:1687-1689.
4. Blomkalns AL, Gibler WB. Markers and the initial triage and treatment of patients with chest pain. Cardiovasc Toxicol. 2001;1:111-115.
5. O'Neil BJ, Ross MA. Cardiac markers protocols in a chest pain observation unit. Emerg Med Clin North Am. 2001;19:67-86.
6. Califf RM, Ohman EM. The diagnosis of acute myocardial infarction. Chest. 1992;101(4 suppl):106S-115S.
7. Storrow AB, Lindsell CJ, Collins SP, et al. Emergency department multimarker point-of-care testing reduces time to cardiac marker results without loss of diagnostic accuracy. Point of Care. 2006;5:132-136.
8. Storrow AB, Lindsell CJ, Han JH, et al. Discordant cardiac biomarkers: frequency and outcomes in emergency department patients with chest pain. Ann Emerg Med. 2006;48:660-665.
9. Karras DJ, Kane DL. Serum markers in the emergency department diagnosis of acute myocardial infarction. Emerg Med Clin North Am. 2001;19:321-337.
10. McCullough PA, Nowak RM, Foreback C, et al. Performance of multiple cardiac biomarkers measured in the emergency department in patients with chronic kidney disease and chest pain. Acad Emerg Med. 2002;9:1389-1396.
11. Malach M, Imperato PJ. Acute myocardial infarction and acute coronary syndrome: then and now (1950-2005). Prev Cardiol. 2006;9:228-234.
12. Graff LG, Wang Y, Borkowski B, et al. Delay in the diagnosis of acute myocardial infarction: effect on quality of care and its assessment. Acad Emerg Med. 2006;13:931-938.
13. Brogan GX Jr, Hollander JE, McCuskey CF, et al. Evaluation of a new assay for cardiac troponin I vs creatine kinase-MB for the diagnosis of acute myocardial infarction. Biochemical Markers for Acute Myocardial Ischemia (BAMI) Study Group. Acad Emerg Med. 1997;4:6-12.
14. Futterman LG, Lemberg L. Novel markers in the acute coronary syndrome: BNP, IL-6, PAPP-A. Am J Crit Care. 2002;11:168-172.
15. Hedges JR, Swanson JR, Heeter C, et al. Prospective assessment of presenting serum markers for cardiac risk stratification. Acad Emerg Med. 1996;3:27-33.
16. Hollander JE, Muttreja MR, Dalesandro MR, et al. Risk stratification of emergency department patients with acute coronary syndromes using P-selectin. J Am Coll Cardiol. 1999;34:95-105.
17. Ohman EM. Troponin and other cardiac markers: role in management of acute coronary syndromes. Aust N Z J Med. 1999;29:436-443.
18. Storrow AB, Gibler WB. The role of cardiac markers in the emergency department. Clin Chim Acta. 1999;284:187-196.
19. Altinier S, Zaninotto M, Mion M, et al. Point-of-care testing of cardiac markers: results from an experience in an emergency department. Clin Chim Acta. 2001;311:67-72.
20. Beyerle K. POC testing of cardiac markers enhances ED care. Nurs Manage. 2002;33:37-39.
21. Collinson PO. The need for a point of care testing: an evidence-based appraisal. Scand J Clin Lab Invest Suppl. 1999;230:67-73.
22. Balk EM, Ioannidis JP, Salem D, et al. Accuracy of biomarkers to diagnose acute cardiac ischemia in the emergency department: a meta-analysis. Ann Emerg Med. 2001;37:478-494.
23. Lau J, Ioannidis JP, Balk EM, et al. Diagnosing acute cardiac ischemia in the emergency department: a systematic review of the accuracy and clinical effect of current technologies. Ann Emerg Med. 2001;37:453-460.
24. Fesmire FM. Improved identification of acute coronary syndromes with delta cardiac serum marker measurements during the emergency department evaluation of chest pain patients. Cardiovasc Toxicol. 2001;1:117-123.
25. Kratz A, Lewandrowski KB, McDermott S, et al. Performance of a point-of-care qualitative triple cardiac marker screen under controlled laboratory conditions and in an emergency department setting. Clin Chim Acta. 2002;325:79-85.
26. McCord J, Nowak RM, McCullough PA, et al. Ninety-minute exclusion of acute myocardial infarction by use of quantitative point-of-care testing of myoglobin and troponin I. Circulation. 2001;104:1483-1488.
27. Ng SM, Krishnaswamy P, Morissey R, et al. Ninety-minute accelerated critical pathway for chest pain evaluation. Am J Cardiol. 2001;88:611-617.
28. Ng SM, Krishnaswamy P, Morrisey R, et al. Mitigation of the clinical significance of spurious elevations of cardiac troponin I in settings of coronary ischemia using serial testing of multiple cardiac markers. Am J Cardiol. 2001;87:994-999, A4.
29. Maisel AS, Templin K, Love M, et al. A prospective study of an algorithm using cardiac troponin I and myoglobin as adjuncts in the diagnosis of acute myocardial infarction and intermediate coronary syndromes in a veteran's hospital. Clin Cardiol. 2000;23:915-920.
30. McCord J, Nowak RM, Hudson MP, et al. The prognostic significance of serial myoglobin, troponin I, and creatine kinase-MB measurements in patients evaluated in the emergency department for acute coronary syndrome. Ann Emerg Med. 2003;42:343-350.
31. Sallach SM, Nowak R, Hudson MP, et al. A change in serum myoglobin to detect acute myocardial infarction in patients with normal troponin I levels. Am J Cardiol. 2004;94:864-867.
32. Fesmire FM, Christenson RH, Fody EP, et al. Delta creatine kinase-MB outperforms myoglobin at two hours during the emergency department identification and exclusion of troponin positive non-ST-segment elevation acute coronary syndromes. Ann Emerg Med. 2004;44:12-19.
33. Wang TJ, Gona P, Larson MG, et al. Multiple biomarkers for the prediction of first major cardiovascular events and death. N Engl J Med. 2006;355:2631-2639.
34. Roberts RR, Zalenski RJ, Mensah EK, et al. Costs of an emergency department-based accelerated diagnostic protocol vs hospitalization in patients with chest pain: a randomized controlled trial. JAMA. 1997;278:1670-1676.
35. Wu AH, Clive JM. Impact of CK-MB testing policies on hospital length of stay and laboratory costs for patients with myocardial infarction or chest pain. Clin Chem. 1997;43:326-332.