The utility of four biochemical markers in the triage of chest pain patients.

Abstract:

:Four biochemical markers, creatine kinase (CK)-MB isoenzyme, myoglobin, myosin light chains and troponin I, were studied in 1,338 patients presenting to the emergency department with chest pain suggestive of coronary artery disease (CAD). One hundred and eighty-seven patients had an acute myocardial infarction (MI). At least one of the four markers was over the threshold on the first sample in 78% of MI patients, as compared to only 40% with an elevated CK-MB. After 4 h, 88% had at least one marker elevated. None of the 69 patients with atypical chest pain, no history of CAD, no markers over threshold on the first sample and a normal electrocardiogram had an acute MI or unstable angina. If we had discharged this group, we would have saved USD 264,000, estimating a cost of USD 2,000 per day. Using four biochemical markers improved the early diagnosis of CAD and may help identify groups suitable for early discharge.

journal_name

Cardiology

journal_title

Cardiology

authors

Ellestad MH,Startt-Selvester R,Stanton E,VanNatta B,Ahmad J,Gawad Y,Swiger F

doi

10.1159/000007033

subject

Has Abstract

pub_date

2000-01-01 00:00:00

pages

242-8

issue

4

eissn

0008-6312

issn

1421-9751

pii

7033

journal_volume

93

pub_type

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