Cardiac markers. Symposium of a panel of experts. Sorrento, ITA, 1998/05/24.
Differential diagnosis of patients who present with chest pain remains problematical.
It has been shown that 11.8-7% of patients with acute myocardial infarction (AMI) are sent home from the emergency department (ED).
Audit of our own ED has shown the incidence of missed prognostically significant myocardial damage to be 6.7%. Diagnostic criteria for AM have classically been based on the triad of history, ECG and measurement of cardiac enzymes.
The choice of'cardiac enzymes'has been dictated by the evolution of laboratory techniques, commencing with measurement of aspartate transaminase and progressing to measurement of creatine kinase (CK) and its MB isoenzyme (CK-MB).
Measurement of CK-MB has been shown by both clinical studies and rigorous statistical analysis to represent the best test for the diagnosis of AMI.
The advent of real time immunoassay together with advances in therapeutic options for management of acute coronary syndromes (ACS) has resulted in a paradigm shift in the approach to laboratory testing.
Immunoassay for CK-MB (CK-MB mass measurement) is diagnostically superior to CK-MB activity measurement and is the test of choice for'classical'AMI.
Development of immunoassays for the cardiac troponins, i.e. cardiac troponin T (cTnT) and cardiac troponin I (cTnl), has enhanced diagnostic specificity. (...)
Mots-clés Pascal : Infarctus, Myocarde, Aigu, Troponine, Creatine kinase, Transferases, Enzyme, Isozyme, Analyse coût, Economie santé, Etude longitudinale, Pronostic, Survie, Homme, Appareil circulatoire pathologie, Cardiopathie coronaire, Myocarde pathologie
Mots-clés Pascal anglais : Infarct, Myocardium, Acute, Troponin, Creatine kinase, Transferases, Enzyme, Isozyme, Cost analysis, Health economy, Follow up study, Prognosis, Survival, Human, Cardiovascular disease, Coronary heart disease, Myocardial disease
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Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0069080
Code Inist : 002B12A03. Création : 31/05/1999.