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July 1, 1996Annals of Clinical Biochemistry International Journal of Laboratory Medicine

Early ‘Rule-In’ Diagnosis of Acute Myocardial Infarction 4 h Post Admission for Rapid Risk Stratification by Creatine Kinase Increment (Creatine Kinase Change)

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Key result

A 4-hour creatine kinase change demonstrated 100% sensitivity (95% CI 96.1-100) and 90.4% specificity (95% CI 83.5-95.1) for the early diagnosis of acute myocardial infarction.

Why the study?

Does serial creatine kinase measurement and ECG accurately diagnose acute myocardial infarction within 4 hours of admission?

Population

248 patients evaluated for acute myocardial infarction, median age 62 years, 187 men and 61 women. Median…

Comparison

Creatine kinase measurement on admission, CK at… vs Final clinical diagnosis of acute myocardial…

Design

Cohort

Follow-up

4 hours

Authors

PCPaul CollinsonGeneral / Preventive / LipidsPSPeter StubbsUniversity of Technology Sydney

Discussion

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Implication

May support early AMI diagnosis with 4-hour CK change; hypothesis-generating and requires prospective validation before practice change.

Study Design

Type

Observational (n=248)

Structured PICO

Does serial creatine kinase measurement and ECG accurately diagnose acute myocardial infarction within 4 hours of admission?

P
Population
248 patients (median age 62 years, 24.6% female) evaluated for early risk stratification and diagnosis of acute myocardial infarction.
E
Exposure
Creatine kinase (CK) measurement on admission, CK at 4 hours, percentage CK change, and electrocardiography (ECG)
C
Comparator
Final clinical diagnosis of acute myocardial infarction (reference standard)
O
Outcome
Sensitivity and specificity for the early diagnosis of acute myocardial infarction

A strategy of admission ECG combined with serial creatine kinase testing allows for accurate diagnosis and risk stratification of acute myocardial infarction within 4 hours of admission.

Limitations

  • Requires further clinical trials to determine if this strategy can be used for selection of therapeutic options.

Cite This Study

Collinson et al. (1996) conducted an observational in Acute myocardial infarction (n=248). 4 h creatine kinase (CK) change vs. Admission ECG and admission CK was evaluated on Diagnosis of acute myocardial infarction. A 4-hour creatine kinase change demonstrated 100% sensitivity (95% CI 96.1-100) and 90.4% specificity (95% CI 83.5-95.1) for the early diagnosis of acute myocardial infarction.

synapsesocial.com/papers/6a9b7ce360e6be7ba549784ahttps://doi.org/10.1177/000456329603300405
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Early Diagnosis of Acute Myocardial Infarction by CK-MB Mass Measurements1992 · 70 citations
  2. 2Diagnosis of acute myocardial infarction from sequential enzyme measurements obtained within 12 hours of admission to hospital.1989 · 36 citations
  3. 3Early diagnosis of acute myocardial infarction by rapid analysis of creatine kinase isoenzyme-3 (CK-MM) sub-types.1987 · 54 citations
  4. 4Use of a Rapid Assay of Subforms of Creatine Kinase MB to Diagnose or Rule Out Acute Myocardial Infarction1994 · 327 citations
  5. 5Early Diagnosis of Myocardial Infarction by Timed Sequential Enzyme Measurements1988 · 60 citations