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A pilot study of cardiac troponin I in patients with acute myocardial infarction and unstable angina.

Abstract

OBJECTIVE

To assess the value of cardiac troponin I in the initial management of acute myocardial infarction and unstable angina, as well as the concordance between creatine phosphokinase-cardiac isoenzyme and cardiac troponin I.

METHODS

We reviewed retrospectively the charts of 32 patients with acute myocardial infarction or unstable angina admitted to the Intensive Care Unit from the Emergency Room of King Khalid Military City Hospital, Hafar-Al-Batin, Kingdom of Saudi Arabia from April 1998 to September 2000. The time of admission to the intensive care unit, which corresponds to the beginning of thrombolytic therapy, the time when cardiac enzymes (creatine phosphokinase-cardiac isoenzyme and cardiac troponin I) are available as well as number of cardiac troponin I determinations before obtaining a significant positive result (>2ng/ml) and the delay between admission and the first significant positive result of cardiac troponin I, were evaluated.

RESULTS

Sixteen patients had confirmed acute myocardial infarction based on the association of typical chest pain, electrocardiographic findings with ST segment elevation and significant increase of the ratio creatine phosphokinase-cardiac isoenzyme/creatine phosphokinase > 10%. Sixteen patients had unstable angina and out of the 16 patients (81.25%) with acute myocardial infarction, 13 received thrombolytic therapy which was initiated on the basis of typical clinical history and electrocardiographic features, before the availability of cardiac enzymes. Troponin I was available in only 13 cases. The number of tests performed in these patients was 32. The first positive result of cardiac troponin I was available within a mean time of 16.66 20.8 hours from admission. The number of negative tests performed before obtaining a frank positive result was 9 in 12 patients. The number of positive tests after having obtained the first frank positive cardiac troponin I result was 10 in 12 patients. In all cases of cardiac troponin I, results were concordant with creatine phosphokinase-cardiac isoenzyme. In the 16 patients with unstable angina, only 11 patients had cardiac troponin I serum level. A total of 21 tests were performed. In 9 patients 14 cardiac troponin I tests were < 2 ng/ml. This was correlated with normal creatine phosphokinase-cardiac isoenzyme/creatine phosphokinase ratio. In 2 patients, 7 cardiac troponin I tests were positive. Both of them had significant increase of creatine phosphokinase-cardiac isoenzyme/creatine phosphokinase ratio and electrocardiographic features of myocardial ischemia and were referred for urgent coronary angiography.

CONCLUSION

Cardiac troponin I levels are not helpful in the initial management of patients with acute myocardial infarction. Thrombolytic therapy should be therefore instituted before the availability of cardiac troponin I results. However, cardiac troponin I results are concordant with creatine phosphokinase-cardiac isoenzyme in retrospective confirmation of the diagnosis of acute myocardial infarction a few hours after onset. In patients with unstable angina, cardiac troponin I should be used mainly for risk stratification.

Authors+Show Affiliations

,

Department of Cardiology, Northern Area Armed Forces Hospital, King Khalid Military City, Hafar-Al-Batin, Kingdom of Saudi Arabia. alawashiz@kkmch.med.sa

Source

Saudi medical journal 23:5 2002 May pg 526-8

MeSH

Adult
Aged
Aged, 80 and over
Angina, Unstable
Biomarkers
Creatine Kinase
Creatine Kinase, MB Form
Critical Care
Electrocardiography
Female
Follow-Up Studies
Humans
Intensive Care Units
Isoenzymes
Male
Middle Aged
Myocardial Infarction
Pilot Projects
Retrospective Studies
Sensitivity and Specificity
Survival Rate
Treatment Outcome
Troponin I

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12070573

Citation

Selim, Najlaa A., and Houssem T. Hmouda. "A Pilot Study of Cardiac Troponin I in Patients With Acute Myocardial Infarction and Unstable Angina." Saudi Medical Journal, vol. 23, no. 5, 2002, pp. 526-8.
Selim NA, Hmouda HT. A pilot study of cardiac troponin I in patients with acute myocardial infarction and unstable angina. Saudi Med J. 2002;23(5):526-8.
Selim, N. A., & Hmouda, H. T. (2002). A pilot study of cardiac troponin I in patients with acute myocardial infarction and unstable angina. Saudi Medical Journal, 23(5), pp. 526-8.
Selim NA, Hmouda HT. A Pilot Study of Cardiac Troponin I in Patients With Acute Myocardial Infarction and Unstable Angina. Saudi Med J. 2002;23(5):526-8. PubMed PMID: 12070573.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A pilot study of cardiac troponin I in patients with acute myocardial infarction and unstable angina. AU - Selim,Najlaa A, AU - Hmouda,Houssem T, PY - 2002/6/19/pubmed PY - 2002/7/24/medline PY - 2002/6/19/entrez SP - 526 EP - 8 JF - Saudi medical journal JO - Saudi Med J VL - 23 IS - 5 N2 - OBJECTIVE: To assess the value of cardiac troponin I in the initial management of acute myocardial infarction and unstable angina, as well as the concordance between creatine phosphokinase-cardiac isoenzyme and cardiac troponin I. METHODS: We reviewed retrospectively the charts of 32 patients with acute myocardial infarction or unstable angina admitted to the Intensive Care Unit from the Emergency Room of King Khalid Military City Hospital, Hafar-Al-Batin, Kingdom of Saudi Arabia from April 1998 to September 2000. The time of admission to the intensive care unit, which corresponds to the beginning of thrombolytic therapy, the time when cardiac enzymes (creatine phosphokinase-cardiac isoenzyme and cardiac troponin I) are available as well as number of cardiac troponin I determinations before obtaining a significant positive result (>2ng/ml) and the delay between admission and the first significant positive result of cardiac troponin I, were evaluated. RESULTS: Sixteen patients had confirmed acute myocardial infarction based on the association of typical chest pain, electrocardiographic findings with ST segment elevation and significant increase of the ratio creatine phosphokinase-cardiac isoenzyme/creatine phosphokinase > 10%. Sixteen patients had unstable angina and out of the 16 patients (81.25%) with acute myocardial infarction, 13 received thrombolytic therapy which was initiated on the basis of typical clinical history and electrocardiographic features, before the availability of cardiac enzymes. Troponin I was available in only 13 cases. The number of tests performed in these patients was 32. The first positive result of cardiac troponin I was available within a mean time of 16.66 20.8 hours from admission. The number of negative tests performed before obtaining a frank positive result was 9 in 12 patients. The number of positive tests after having obtained the first frank positive cardiac troponin I result was 10 in 12 patients. In all cases of cardiac troponin I, results were concordant with creatine phosphokinase-cardiac isoenzyme. In the 16 patients with unstable angina, only 11 patients had cardiac troponin I serum level. A total of 21 tests were performed. In 9 patients 14 cardiac troponin I tests were < 2 ng/ml. This was correlated with normal creatine phosphokinase-cardiac isoenzyme/creatine phosphokinase ratio. In 2 patients, 7 cardiac troponin I tests were positive. Both of them had significant increase of creatine phosphokinase-cardiac isoenzyme/creatine phosphokinase ratio and electrocardiographic features of myocardial ischemia and were referred for urgent coronary angiography. CONCLUSION: Cardiac troponin I levels are not helpful in the initial management of patients with acute myocardial infarction. Thrombolytic therapy should be therefore instituted before the availability of cardiac troponin I results. However, cardiac troponin I results are concordant with creatine phosphokinase-cardiac isoenzyme in retrospective confirmation of the diagnosis of acute myocardial infarction a few hours after onset. In patients with unstable angina, cardiac troponin I should be used mainly for risk stratification. SN - 0379-5284 UR - https://www.unboundmedicine.com/medline/citation/12070573/A_pilot_study_of_cardiac_troponin_I_in_patients_with_acute_myocardial_infarction_and_unstable_angina_ L2 - https://medlineplus.gov/heartattack.html DB - PRIME DP - Unbound Medicine ER -