Open AccessEffectiveness to identify acute myocardial infarction using the Manchester screening in patients with chest pain at the emergency service
Author(s) -
Gonçalves Simone M.,
Gomes Karina B.,
Carvalho Maria das G.,
Magalhães Henrique P. B.,
Reis Edna A.,
Silva Iêda de Fátima O.
Publication year - 2018
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.22439
Subject(s) - medicine , chest pain , myocardial infarction , cardiology , cardiac marker , emergency department , acute coronary syndrome , unstable angina , troponin , troponin i , triage , creatine kinase , angina , emergency medicine , psychiatry
Background Among cardiovascular diseases (CVD), acute coronary syndrome (ACS) is the main manifestation, corresponding to signs and symptoms that occur with ischemia and outcome of angina or acute myocardial infarction (AMI). The aim of this study was to investigate the performance of biochemical markers eligible in a chest pain protocol, using Point of care Test (POCT), in patients in a reference emergency room. Methods In this study, 1380 medical records of patients of both genders were evaluated, ranked by applying chest pain protocol using the Manchester Triage System (MTS). Markers for myocardial injury were measured in serial analysis including myoglobin (Mgb), creatine kinase MB fraction mass (CK‐MB), and cardiac troponin I (cTnI). Results Acute myocardial infarction was predominant in males ( P < .001), in patients with hypertension ( P < .001), and in those with previous myocardial infarction ( P < .026) and significant electrocardiogram (ECG) data for AMI screening ( P < .001). A multivariate regression model showed as predictors for AMI the variables ECG data by admittance at the emergency room, previous AMI history, levels of both Mgb at the third hour, and cTnI at the sixth hour after admission. Conclusion This study showed the importance of a rapid and serial test as a cardiac marker for AMI screening, as well as has indicated the importance of time between the onset of chest pain and admission to the emergency room as an efficient aid in diagnosing this life‐threatening disease.