Effect of recent cocaine use on the specificity of cardiac markers for diagnosis of acute myocardial infarction
Why the study?
Does recent cocaine use alter the specificity of cardiac markers for diagnosing acute myocardial infarction in patients presenting with chest pain?
Population
97 patients <60 years old seen in the emergency department for chest pain with potential myocardial ischemia.
Comparison
Recent cocaine use vs No recent cocaine use
Design
Cross-sectional
Authors
Discussion
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Member takes
Implication
May limit myoglobin use for AMI in cocaine users; leaves open troponin's reliability pending prospective validation.
Structured PICO
Does recent cocaine use alter the specificity of cardiac markers for diagnosing acute myocardial infarction in patients presenting with chest pain?
P
Population
97 patients <60 years old seen in the emergency department for chest pain with potential myocardial ischemia.
I
Intervention
Recent cocaine use (confirmed by presence of benzoylecgonine metabolite)
C
Comparator
No recent cocaine use
O
Outcome
Specificity of cardiac markers (CK-MB, myoglobin, and cardiac troponin I) for the diagnosis of acute myocardial infarction (AMI)surrogate
Recent cocaine use reduces the diagnostic specificity of myoglobin for acute myocardial infarction, but does not affect the specificity of cardiac troponin I, supporting the preferential use of troponin in this population.
Cite This Study
Hollander et al. (1998) studied this question.