[Automated measurement of biomarkers for the diagnosis of acute myocardial infarction].

INTRODUCTION Cardiac biomarkers have a prominent role in the diagnosis of acute myocardial infarction. AIM The aim of the authors was to study the diagnostic effectiveness of automated measurement of cardiac biomarkers. METHOD Myeloperoxidase, high-sensitivity C-reactive protein, myoglobin, heart-type fatty acid binding protein, creatine kinase, creatine kinase MB, high-sensitivity troponin I and T were measured. RESULTS The high-sensitivity troponin I was the most effective (area under curve: 0.86; 95% confidence interval: 0.77-0.95; p<0.001) for the diagnosis of acute myocardial infarction. Considering a critical value of 0.35 ng/mL, its sensitivity and specificity were 81%, and 74%, respectively. Combined evaluation of the high-sensitivity troponin T and I, chest pain, and the electrocardiogram gave the best results for separation of acute myocardial infarction from other diseases (correct classification in 62.5% and 98.9% of patients, respectively). CONCLUSIONS Until a more sensitive and specific cardiac biomarker becomes available, the best method for the diagnosis of acute myocardial infarction is to evaluate electrocardiogram and biomarker concentration and to repeat them after 3-6 hours.