cardiac enzyme in emergency medicine
نویسندگان
چکیده
acute chest pain is an important and frequently occurring symptom in patients. chest pain is often a sign of ischemic heart disease. chest pain due to suspected acute coronary syndrome (acs) is responsible for a large and increasing number of hospital attendances and admissions. current practice for suspected acs involves troponin testing 10–12 hours after symptom onset to diagnose myocardial infarction (mi). patients with a negative troponin can be investigated further with computed tomographic coronary angiography (ctca) or exercise electrocardiography (ecg). a review of cardiac biomarkers as screening test in acute chest pain over 15 years was conducted. separate searches were under taken for biomarkers. we searched electronic databases up to 2004-2014, reviewed citation lists and contacted experts to identify diagnostic and prognostic studies comparing a relevant index test (biomarker, ctca or exercise ecg) to the appropriate reference standard. we classified studies to two part early rise biomarkers, high sensitivity biomarkers. conclusion: although presentation troponin has suboptimal sensitivity, measurement of a 10-hour troponin level is unlikely to be cost-effective in most scenarios compared with a high sensitivity presentation troponin. measurement of cardiac troponin using a sensitive method was the best test for the early diagnosis of an acute myocardial infarction (ami). measurement of myoglobin or creatine kinase-mb (ck-mb) in addition to a sensitive troponin test is not recommended. heart-type fatty acid-binding protein (h-fabp) shows promise as an early marker and requires further study.
منابع مشابه
Cardiac enzyme in emergency medicine
Objective: Acute chest pain is an important and frequently occurring symptom in patients. Chest pain is often a sign of ischemic heart disease. Chest pain due to suspected Acute Coronary Syndrome (ACS) is responsible for a large and ijncreasing number of hospital attendances and admissions. Current practice for suspected ACS involves troponin testing 10–12 hours after symptom o...
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عنوان ژورنال:
journal of emergency practice and traumaجلد ۱، شماره ۱، صفحات ۲۹-۳۴
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