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
Cardiologyjournal_title
Cardiologyauthors
Ellestad MH,Startt-Selvester R,Stanton E,VanNatta B,Ahmad J,Gawad Y,Swiger Fdoi
10.1159/000007033subject
Has Abstractpub_date
2000-01-01 00:00:00pages
242-8issue
4eissn
0008-6312issn
1421-9751pii
7033journal_volume
93pub_type
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