Availability of Troponin I and T and CK-MB for Diagnosis of Acute Myocardial Infarction in Patients of Renal Failure Admited to an Emergency Medical Center.
- Author:
Gyeong Jin KIM
1
;
Soo Hyeong CHO
;
Nam Soo CHO
Author Information
1. Department of Emergency Medicine, Chosun University Hospital, Kwangju, Korea. chosooh@hanmail.net
- Publication Type:Original Article
- Keywords:
Myocardial infarction;
CK-MB;
cTnT;
cTnI;
Creatinine
- MeSH:
Chest Pain;
Creatinine;
Diagnosis*;
Diagnosis, Differential;
Dyspepsia;
Dyspnea;
Electrocardiography;
Emergencies*;
Humans;
Hypercholesterolemia;
Myocardial Infarction*;
Obesity;
Renal Insufficiency*;
Risk Factors;
Sensitivity and Specificity;
Smoke;
Smoking;
Troponin I*;
Troponin*
- From:Journal of the Korean Society of Emergency Medicine
2002;13(4):485-488
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Generally, if a patient suffers from chest pain and shows a specific EKG pattern, it is easy to determine a clinical diagnosis, thus it is but in many cases, patients show nonspecific chest pain and a nonspecific EKG pattern. So it's important to consider the serological labaratory exam for cardiac enzymes for a definite diagnosis. Until now, cTnI has been considered to be different from CK-MB and cTnT in that it shows a specific elevation in early myocardiac injury and rare nonspecific elevation in renal-failure patients. Therefore, to affirm a sufficient relation between cTnI elevation and myocardiac injury, are carried out this study. METHODS: The number of patients in the study was 58. No one had shown any evidence of myocardiac injury during the recent 2 years or any of the risk factors for AMI, such as smoking, obesity, and hypercholesterolemia. They showed specific symptoms like chest pain or nonspecific ones like dyspnea, indigestion, or a nonspecific EKG abnormality, including nonspecific ST-T change. Their serum creatinine level was above 2.0 mg/dL and qualitative results of cTnI was obtained by using a Troponin I rapid assay kit. The definite diagnosis of AMI was made by a cardiologist based on an intergrated result of EKG, clinical symptoms and signs and regional cardiac wall-motion abnormality on a echocardiogram. RESULTS: The sensitivity of CK-MB, cTnT, and cTnI were 100%, 100%, and 100%, respectively, and the specificities were 75%, 85%, 100%. CONCLUSION: In cases of patients with a high serum-creatinine level, particularly, those with positive serum CK-MB and cTnT, the measurement of cTnI is considered to be significant for the differential diagnosis of AMI as it shows both a high sensitivity and a high specificity in early myocardiac injury.
