Ruling Out Myocardial Infarction with Troponin T and Creatine Kinase MB Mass: Diagnostic and Prognostic Aspects |
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Authors: | Heli Koukkunen Karri Penttilä Ari Kemppainen Ilkka Penttilä Matti Halinen Tapio Rantanen Kalevi Pyörälä |
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Affiliation: | 1. Department of Medicine,;2. Department of Clinical Chemistry, Kuopio University Hospital, Kuopio;3. Department of Medicine, Turku University Central Hospital, Turku,;4. Accident and Emergency Department, Kuopio University Hospital, Kuopio, Finland |
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Abstract: | Objective - To investigate the time window for ruling out myocardial infarction (MI) with troponin T (TnT) and creatine kinase isoenzyme MB mass (CK-MBm) and the prognosis of patients with ruled-out MI diagnosis. Design - The study was based on 397 patients admitted with a suspected acute coronary syndrome but with relief of symptoms within 24 h. Results - MI diagnosis was confirmed with elevated TnT (> 0.10 µg/l) in 108 patients, in 91% within 12-24 h from the onset of symptoms, and in 99% within 12 h from admission. In 94 of these patients CK-MBm became elevated (> 5.0 µg/l), in 95% within 10-12 h from the onset of symptoms, and in 99% within 6 h from admission. Among patients with ruled-out MI diagnosis, the 1-year incidence of recurrent coronary events was 29% in those with positive history of coronary heart disease (CHD) but only 7% in those without prior CHD ( p < 0.001). Conclusion - Using TnT or CK-MBm, MI can be ruled out within 12 h from admission in the majority of patients. Among patients with ruled-out MI diagnosis, positive history of CHD is an important determinant of prognosis. |
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Keywords: | Ck-MB Mass Finmonica Myocardial Infarction Troponin T |
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