Diagnostic and prognostic significance of high sensitive troponin in chest pain.
نویسندگان
چکیده
BACKGROUND AND OBJECTIVES Chest pain is one of the most frequent presenting complaints among patients arriving to the Emergency Department. In this population, the prevalence of acute coronary syndrome is about 25% instead that of acute myocardial infarction ranges from 5 to 15%. The diagnostic challenge for the emergency physician is the early rule-in or rule out of acute myocardial infarction within first few hours after chest pain presentation, particularly in those patients with normal or not significant electrocardiogram. EVIDENCE AND INFORMATION SOURCES The current review is based on an analysis of most important clinical trials on this topic. STATE OF THE ART The universal current guidelines established that the term "myocardial infarction" should be used when there is evidence of myocardial necrosis of ischemic origin, as documented by an increase of myocardial necrosis markers. Actually, cardiac troponins are considered the standard biomarkers for acute myocardial infarction diagnosis, because are more superior in sensitivity and specificity to the other available markers. PERSPECTIVES More recently, high sensitive troponin assays have been developed, permitting the early measurement of very low concentrations. CONCLUSION In this review, we analyzed the diagnostic and prognostic significance of these new high sensitive troponins in Emergency Department chest pain management.
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...
متن کاملThe most sensitive double-marker method of cardiac isoenzymes of creatinine kinase, troponin I, and myoglobin in different time periods for diagnosing acute myocardial infarction
Purpose: Myocardial infarction is among the most common diagnoses in patients admitted to hospitals in western countries, and its rapid diagnosis is of utmost importance. This study was conducted to determine the most sensitive double-marker cardiac isoenzyme of creatinine kinase, troponin I, and myoglobin for diagnosing acute myocardial infarction. Materials and Methods: This was an ...
متن کاملHigh Sensitivity Troponin (at 0 & 2 Hrs) in Emergency Department. Will Reducing the Interval Time, Safely Reduce Admissions and Costs?
Every four minutes someone is admitted to hospital suffering from a heart attack or a chest pain event in the UK, totalling over 150,000 hospitalisations a year. Chest pain is one of the most common presentations in the emergency department and quite a few of them get admitted as low risk ACS patients. With the developments in technology, we have increasingly sensitive troponin assays available...
متن کاملChest pain and high troponin level without significant respiratory symptoms in young patients with COVID-19
Background: Of all patients infected with COVID-19, 95% have mild symptoms, but 5% may experience severe illness. There are reports of myocardial injury associated with the COVID19 infection in middle aged and old people with baseline cardiac conditions. Acute myocardial injury has been suggested as a marker for disease severity. Sometimes it is hard to differentiate between acute coronary synd...
متن کاملA rapid troponin-I-based protocol for assessing acute chest pain.
In a prospective randomized open trial with 30-day follow-up, we compared a troponin-I-based protocol to 'standard management' for the diagnosis and risk stratification of patients with acute non-ST-elevation chest pain. Patients with acute chest pain (n=400) were randomized to standard diagnostic tests and management, or a protocol based on the admission ECG and the troponin-I result 6 h after...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- European review for medical and pharmacological sciences
دوره 15 6 شماره
صفحات -
تاریخ انتشار 2011