A Rapid Point-of-Care Cardiac Marker Testing Strategy Facilitates the Rapid Diagnosis and Management of Chest Pain Patients in the Emergency Department

医学 胸痛 急诊科 心肌梗塞 肌钙蛋白I 内科学 心脏病学 心脏标志物 肌酸激酶 肌钙蛋白 检测点注意事项 心肌梗死诊断 肌红蛋白 急性冠脉综合征 病理 有机化学 化学 精神科
作者
Angela L. Straface,John H Myers,Howard J. Kirchick,Kenneth E. Blick
出处
期刊:American Journal of Clinical Pathology [Oxford University Press]
卷期号:129 (5): 788-795 被引量:50
标识
DOI:10.1309/9ggnmurljwjd88w3
摘要

We compared a rapid, point-of-care multimarker protocol with a single and serial troponin I (TnI)-only protocol in 5,244 patients admitted to the emergency department with chest pain. The diagnosis of acute myocardial infarction (AMI) was based on a doubling myoglobin level accompanied by at least a 50% increase in the creatine kinase (CK)-MB level with no detectable TnI; a doubling of myoglobin level together with any detectable TnI; or a TnI level of 0.4 ng/mL (0.4 μg/L) or more, irrespective of myoglobin or CK-MB results. By using these new criteria, 145 of 148 cases were positive for AMI (positive predictive value [PPV], 92.4%) and 3 were negative, which were also negative by the core laboratory TnI assay. Twelve confirmed non-AMI cases were positive by the new protocol, with 10 of 12 confirmed by the core laboratory as positive for TnI. The negative predictive value (NPV) was 99.9%; the overall diagnostic accuracy was 99.7%. The TnI-only protocol had a sensitivity of 68.2% with an NPV of 99.1%. With lower TnI-only cutoffs, 4 patients had false-negative results, and a PPV of 36.4% was observed. Our rapid multimarker protocol seems superior to a TnI-only approach for rapidly triaging patients with chest pain or AMI.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
善学以致用应助KK采纳,获得10
1秒前
黑桃Q发布了新的文献求助10
1秒前
2秒前
FashionBoy应助认真初之采纳,获得10
5秒前
吴子鹏完成签到,获得积分10
5秒前
风清扬应助范范采纳,获得10
6秒前
茹茹完成签到,获得积分10
6秒前
7秒前
xzby发布了新的文献求助10
7秒前
陶醉世德完成签到,获得积分10
7秒前
猪猪hero应助清神安采纳,获得10
8秒前
9秒前
Rondab应助幸福大白采纳,获得30
10秒前
孙福禄应助LEOhard采纳,获得10
11秒前
enchanted完成签到,获得积分10
15秒前
FashionBoy应助机智的水风采纳,获得10
15秒前
忐忑的麦片完成签到,获得积分10
16秒前
852应助Liolsy采纳,获得10
16秒前
如此这般关注了科研通微信公众号
17秒前
爆米花应助Zhou采纳,获得10
17秒前
汤成莉完成签到 ,获得积分10
17秒前
Rondab应助幸福大白采纳,获得30
18秒前
科目三应助陈曦采纳,获得10
19秒前
大鱼应助好好好采纳,获得10
19秒前
enchanted发布了新的文献求助10
19秒前
20秒前
20秒前
22秒前
23秒前
小鼠星球完成签到,获得积分20
23秒前
黑桃Q完成签到,获得积分10
24秒前
25秒前
25秒前
26秒前
传奇3应助surong采纳,获得10
27秒前
27秒前
英姑应助Georges-09采纳,获得10
28秒前
研友_VZG7GZ应助会飞的扁担采纳,获得10
28秒前
火柴盒发布了新的文献求助10
29秒前
比利时光完成签到,获得积分10
29秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
‘Unruly’ Children: Historical Fieldnotes and Learning Morality in a Taiwan Village (New Departures in Anthropology) 400
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3989510
求助须知:如何正确求助?哪些是违规求助? 3531756
关于积分的说明 11254536
捐赠科研通 3270255
什么是DOI,文献DOI怎么找? 1804947
邀请新用户注册赠送积分活动 882113
科研通“疑难数据库(出版商)”最低求助积分说明 809176