The new ACC/ESC definition of myocardial infarction using high sensitivity cardiac troponin I increased the apparent incidence of infarction to 40%, compared with 29% using conventional criteria.
Observational (n=80)
No
Does the new ACC/ESC definition based on cardiac troponin increase the apparent incidence of myocardial infarction compared to conventional criteria in patients with suspected ischemic acute chest pain?
The adoption of the new ACC/ESC definition of myocardial infarction using high sensitivity cardiac troponin substantially increases the apparent incidence of the condition compared to conventional biomarkers.
Absolute Event Rate: 40% vs 29%
OBJECTIVES: To investigate the impact of the redefinition of the diagnostic criteria for myocardial infarction on its apparent incidence in a non-selected and representative series of patients admitted with acute chest pain. DESIGN: Single centre prospective study. SETTING: Medical assessment unit and cardiology wards of an inner city university hospital. PATIENTS: 80 consecutive patients aged over 25 years admitted with suspected ischaemic acute chest pain (excluding those where the ECG indicated definite myocardial infarction). INTERVENTIONS: Measurement of concentrations of conventional cardiac biomarkers (creatine kinase and its MB isoenzyme, CK-MB) and concentrations of the highly specific diagnostic indicator of myocardial damage, cardiac troponin I (cTnI) 12-24 hours after the onset of acute chest pain. MAIN OUTCOME MEASURES: Frequency of myocardial infarction as assessed by conventional diagnostic criteria (creatine kinase and CK-MB) plus clinical symptoms of infarction, versus frequency of infarction based on high sensitivity troponin assays. RESULTS: Among patients with acute coronary syndromes but non-diagnostic ECG changes, 40% (32/80) fulfilled the new criteria for myocardial infarction using high sensitivity cTnI measurement, compared with 29% (23/80) using the conventional diagnostic criteria for myocardial infarction. CONCLUSIONS: The implications of the redefinition of myocardial infarction on patients, their care, and the use of health care resources are substantial.
Jamie Ferguson (2002) conducted an observational in suspected ischaemic acute chest pain (n=80). New ACC/ESC definition of myocardial infarction using high sensitivity cardiac troponin I (cTnI) vs. Conventional diagnostic criteria (creatine kinase and CK-MB) was evaluated on Frequency of myocardial infarction. The new ACC/ESC definition of myocardial infarction using high sensitivity cardiac troponin I increased the apparent incidence of infarction to 40%, compared with 29% using conventional criteria.