Myoglobin demonstrated 100% sensitivity for the early diagnosis of myocardial infarction in patients presenting with chest pain and non-diagnostic electrocardiograms.
Observational (n=37)
Does the combination of cardiac markers improve early diagnosis of myocardial infarction and prognosticate adverse events in patients presenting early with suspected acute coronary syndrome?
Myoglobin is highly sensitive for early MI diagnosis in suspected ACS with non-diagnostic ECGs, while isolated troponin I elevation predicts higher 3-month MACE risk.
Effect estimate: 100% sensitivity
OBJECTIVE: The aim of the study was to investigate and compare the usefulness and accuracy of various cardiac markers troponin I, creatine kinase MB (CKMB) mass, creatine kinase (CK), CKMB activity to aid early diagnosis of myocardial infarction. We also examined the ability of the various cardiac markers to prognosticate future adverse cardiac events. MATERIALS AND METHODS: Patients admitted within 8 hours of maximal chest pain suggestive of acute coronary syndrome with non-diagnostic electrocardiograms were recruited. Blood samples were obtained on admission to the wards and repeated 4 hours later. These results were later correlated to the final hospital discharge diagnosis. RESULTS: The 37 patients in the study were a high-risk population with over 50% presenting with a Thrombolysis in Myocardial Infarction (TIMI) risk score of greater or equal to 3. Myoglobin was the most sensitive marker (100% sensitivity) in early prediction of patients who were subsequently diagnosed to have a myocardial infarction. Patients with an elevated troponin I level but normal CK and myoglobin levels had a significantly higher risk of developing a major adverse clinical event (MACE) within 3 months of the initial presentation. CONCLUSION: Myoglobin is the most sensitive marker when compared to CK, CKMB and troponin I for diagnosing patients presenting early with chest pain and a non-diagnostic electrocardiogram and who subsequently develop either a ST-elevation myocardial infarction or non-ST elevation myocardial infarction. Patients with an elevated troponin I level but normal CK and myoglobin levels are at higher risk of an adverse clinical event.
Lim et al. (Fri,) conducted a observational in Suspected acute coronary syndrome (n=37). Cardiac markers (myoglobin, troponin I, CK, CKMB) was evaluated on Early diagnosis of myocardial infarction (100% sensitivity). Myoglobin demonstrated 100% sensitivity for the early diagnosis of myocardial infarction in patients presenting with chest pain and non-diagnostic electrocardiograms.