Open AccessEarly Diagnosis of Acute Myocardial Infarction by Bedside Multimarker Test at an Emergency Department in Hong Kong
Author(s) -
Ho CH,
Cheng W,
Chu G,
Ho HF
Publication year - 2010
Publication title -
hong kong journal of emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.145
H-Index - 12
eISSN - 2309-5407
pISSN - 1024-9079
DOI - 10.1177/102490791001700206
Subject(s) - medicine , emergency department , myocardial infarction , point of care testing , likelihood ratios in diagnostic testing , cardiology , chest pain , receiver operating characteristic , troponin i , myocardial infarction diagnosis , troponin , point of care , creatine kinase , pathology , psychiatry
Cardiac biomarker measurement can aid diagnosis of acute myocardial infarction. The present study evaluates the efficacy and efficiency of point‐of‐care multimarkers measurement of myoglobin, creatine kinase (CK‐MB) and troponin in identifying patients with acute myocardial infarction. Method We prospectively enrolled consecutive patients (N=105) in the emergency department who were being evaluated for possible acute myocardial infarction. Point‐of‐care testing (POCT) of myoglobin, CK‐MB and troponin I (TnI) was performed in all patients. Central laboratory measurement of troponin I was also performed simultaneously. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and receiver operating characteristic (ROC) curve were evaluated. Result The specificity and positive likelihood ratio of TnI (POCT) and TnI (laboratory) were 98%, 13.0 and 98%, 21.8 respectively. The areas under curve of the ROC curve of TnI (POCT) and TnI (laboratory) were 0.692 and 0.725 respectively. Conclusion A high positive likelihood ratio for acute myocardial infarction through point‐of‐care testing can help timely diagnosis and just‐in‐time appropriate management for patients presenting with chest pain.