Rapid risk stratification in suspected acute coronary syndrome using serial multiple cardiac biomarkers: A pilot study

EMA - Emergency Medicine Australasia

Volumn 20, Issue 5, 2008, Pages 403-409

  Macdonald, Stephen P J ^a,b   Nagree, Yusuf ^b  

^a FREMANTLE HOSPITAL   (Australia)

^b Armadale Health Service   (Australia)

Author keywords

Acute coronary syndrome; Chest pain; Emergency; Point of care biomarker; Risk stratification

Indexed keywords

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

ACUTE CORONARY SYNDROME; ADULT; ARTICLE; BLOOD ANALYSIS; CARDIOVASCULAR RISK; CLINICAL TRIAL; CREATININE BLOOD LEVEL; DIAGNOSTIC VALUE; ELECTROCARDIOGRAM; EMERGENCY WARD; FEMALE; FOLLOW UP; HEART INFARCTION; HOSPITAL DISCHARGE; HUMAN; LABORATORY TEST; MAJOR CLINICAL STUDY; MALE; OUTPATIENT CARE; PATIENT CODING; PILOT STUDY; POINT OF CARE TESTING; PREDICTOR VARIABLE; PRIORITY JOURNAL; RISK ASSESSMENT; SENSITIVITY ANALYSIS;

ACUTE CORONARY SYNDROME; BIOLOGICAL MARKERS; CHEST PAIN; CREATINE KINASE, MB FORM; DIAGNOSIS, DIFFERENTIAL; FEMALE; HUMANS; MALE; MIDDLE AGED; PILOT PROJECTS; POINT-OF-CARE SYSTEMS; RISK ASSESSMENT; SENSITIVITY AND SPECIFICITY; TRIAGE; TROPONIN I;

EID: 54049114646     PISSN: 17426731     EISSN: 17426723     Source Type: Journal    
DOI: 10.1111/j.1742-6723.2008.01116.x     Document Type: Article

References (19)

1. Aroney CN, Aylward P, Kelly A-M, Chew DPB, Clune E, National Heart Foundation of Australia and Cardiac Society of Australia and New Zealand. Guidelines for the Management of Acute Coronary Syndromes 2006. Med. J. Aust. 2006 184 : S1 32.
2. Ng SM, Krishnaswamy P, Morissey R, Clopton P, Fitzgerald R, Maisel AS. Ninety-minute accelerated critical pathway for chest pain evaluation. Am. J. Cardiol. 2001 88 : 611 17.
3. McCord J, Nowak RM, McCulloch 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 8.
4. Newby LK, Storrow AB, Gibler WB et al. Bedside multimarker testing for risk stratification in chest pain units: the chest pain evaluation by creatinine kinase-MB, myoglobin and troponin I (CHECKMATE) study. Circulation 2001 103 : 1832 7.
5. Antman E, Bassand J-P, Klein W et al. Myocardial infarction redefined - a consensus document of The Joint European Society of Cardiology/American College of Cardiology Committee for the redefinition of myocardial infarction. JACC 2000 36 : 959 69.
6. Amsterdam EA, Ezra A, Bedside evaluation of cardiac markers. Postgrad. Med. 2005 118 (3 15 22.
7. Karras DJ, Kane DL. Serum markers in the emergency department diagnosis of acute myocardial infarction. Emerg Med. Clin. North Am. 2001 19 (2 321 37.
8. Singer AJ, Ardise J, Gulia J, Cangro J. Point-of-care testing reduces length of stay in emergency department chest pain patients. Ann. Emerg. Med. 2005 45 : 587 91.
9. Apple FS, Christenson RH, Valdes R et al. Simultaneous rapid measurement of whole blood myoglobin, creatinine kinase-MB, and cardiac troponin I by the Triage cardiac panel for detection of myocardial infarction. Clin. Chem. 1999 45 : 199 205.
10. National Academy of Clinical Biochemistry. Biomarkers of Acute Coronary Syndromes and Heart Failure 2007. [Cited 15 March 2008.] Available from URL: http://www.aacc.org
11. Straface AL, Myers JH, Kirchick HJ. Comparison of point of care (POC) testing strategies for rapid emergency department diagnosis of acute myocardial infarction (AMI). Scientific Poster presented at AACC CPOCT meeting, Quebec City, Canada, September 2006.
12. Christenson J, Innes G, McKnight D et al. A clinical prediction rule for early discharge of patients with chest pain. Ann. Emerg. Med. 2006 47 (1 1 10.
13. Fesmire FM, Hughes AD, Fody EP et al. The Erlanger Chest Pain Evaluation Protocol: a one year experience with serial 12-lead ECG monitoring, two-hour delta serum marker measurements, and selective nuclear stress testing to identify and exclude Acute Coronary Syndromes. Ann. Emerg. Med. 2002 40 : 584 94.
14. Antman EM, Cohen M, Berninck PJ et al. The TIMI risk score for Unstable Angina/Non-ST elevation MI. A method for prognostication and therapeutic decision making. JAMA 2000 284 : 835 42.
15. Jaffe AS, Babuin L, Apple FS. Biomarkers in acute cardiac disease. J. Am. Coll. Cardiol. 2006 48 (1 1 11.
16. Agewall S, Olsson T, Lowbeer C. Usefulness of Troponin levels below the diagnostic cut-off level for Acute Myocardial Infarction in predicting prognosis in unselected patients admitted to the Coronary Care Unit. Am. J. Cardiol. 2007 99 : 1357 9.
17. McNeil A. The trouble with troponin. Heart Lung Circ. 2007 16 (Suppl. 3 S13 16.
18. Pope JH, Aufderheide TP, Ruthazer MPH et al. Missed diagnoses of acute cardiac ischaemia in the emergency department. N. Engl. J. Med. 2000 342 : 1163 70.
19. Pines JM, Szyld D. Risk tolerance for the exclusion of potentially life-threatening diseases in the ED. Am. J. Emerg. Med. 2007 25 : 540 4.