Cardiac enzyme in emergency medicine

Shams Vahdati, Samad; Parnianfard, Neda; Beigzali, Sanaz; Tajoddini, Shahrad

Document Type : Review Article

Authors

¹ Department of Emergency Medicine, Tabriz University of Medical Science, Tabriz, Iran

² Student’s Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran

³ Kerman Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran

Abstract

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 onset to diagnose Myocardial Infarction (MI). Patients with a negative troponin can be investigated further with Computed Tomographic Coronary Angiography (CTCA) or exercise Electrocardiography (ECG). A review of cardiac biomarkers as screening test in acute chest pain over 15 years was conducted. Separate searches were under taken for biomarkers. We Searched electronic databases up to 2004-2014, reviewed citation lists and contacted experts to identify diagnostic and prognostic studies comparing a relevant index test (biomarker, CTCA or exercise ECG) to the appropriate reference standard. We classified studies to two part early rise biomarkers, high sensitivity biomarkers.

Conclusion: Although presentation troponin has suboptimal sensitivity, measurement of a 10-hour troponin level is unlikely to be cost-effective in most scenarios compared with a high sensitivity presentation troponin. Measurement of cardiac troponin using a sensitive method was the best test for the early diagnosis of an Acute Myocardial Infarction (AMI). Measurement of myoglobin or Creatine Kinase-MB (CK-MB) in addition to a sensitive troponin test is not recommended. Heart-type Fatty Acid-Binding Protein (H-FABP) shows promise as an early marker and requires further study.

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Journal of Emergency Practice and Trauma

Cardiac enzyme in emergency medicine

References

References

Volume 1, Issue 1 - Serial Number 1
January 2015
Pages 29-34

Cardiac enzyme in emergency medicine

References

References

Volume 1, Issue 1 - Serial Number 1January 2015Pages 29-34

Volume 1, Issue 1 - Serial Number 1
January 2015
Pages 29-34