The DOI matches its Crossref record; 14 of the 14 references it cites were found in a registry or an index.
Diagnostic Marker Cooperative Study for the Diagnosis of Myocardial Infarction
Open accessAbstract
Background —Millions of patients present annually with chest pain, but only 10% to 15% have myocardial infarction. Lack of diagnostic sensitivity and specificity of clinical and conventional markers prevents or delays treatment and leads to unnecessary costly admissions. Comparative data are lacking on the new markers, yet using all of them is inappropriate and expensive. Methods and Results —The Diagnostic Marker Cooperative Study was a prospective, multicenter, double-blind study with consecutive enrollment of patients with chest pain presenting to the emergency department. Diagnostic sensitivity and specificity and frequency of increase in patients with unstable angina were determined for creatine kinase-MB (CK-MB) subforms, myoglobin, total CK-MB (activity and mass), and troponin T and I on the basis of frequent serial sampling for ≤24 hours. Of 955 patients with chest pain, 119 (12.5%) had infarction identified by use of CK-MB mass, and 203 (21%) had unstable angina. CK-MB subforms were most sensitive and specific (91% and 89%) within 6 hours of onset, followed by myoglobin (78% and 89%). For late diagnosis, total CK-MB activity (derived from subforms) was the most sensitive and specific (96% and 98%) at 10 hours from onset, followed by troponin I (96% and 93%), but not until 18 hours, and troponin T (87% and 93% at 10 hours). In unstable angina, CK-MB subforms were increased in 29.5%, myoglobin in 23.7%, troponin I in 19.7%, and troponin T in 14.8%. All markers were increased in 99 patients. With each marker as the diagnostic standard, CK-MB subforms and myoglobin remained the most sensitive for early diagnosis. Conclusions —The CK-MB subform assay alone or in combination with a troponin reliably triages patients with chest pain and should lead to improved therapy and reduced cost.
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Cites
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Cited by
Braunwald, E., Antman, E. M., Beasley, J. W., Califf, R. M., Cheitlin, M. D., Hochman, J. S., Jones, R. H., Kereiakes, D., Kupersmith, J., Levin, T. N., et al. (2000) · Circulation · doi:10.1161/01.cir.102.10.1193 · Cited by 4,487
Braunwald, E., Antman, E. M., Beasley, J. W., Califf, R. M., Cheitlin, M. D., Hochman, J. S., Jones, R. H., Kereiakes, D., Kupersmith, J., Levin, T. N., et al. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)00889-5 · Cited by 963
Troponin: the biomarker of choice for the detection of cardiac injury
Babuin, L., & Jaffe, A. S. (2005) · Canadian Medical Association Journal · doi:10.1503/cmaj.050141 · Cited by 686
1999 update: ACC/AHA guidelines for the management of patients with acute myocardial infarction
Ryan, T. J., Antman, E. M., Brooks, N. H., Califf, R. M., Hillis, L. D., Hiratzka, L. F., Rapaport, E., Riegel, B., Russell, R. O., Smith, E. E., et al. (1999) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(99)00351-4 · Cited by 592
Metadata
- Authors
- Zimmerman, J., Fromm, R., Meyer, D., Boudreaux, A., Wun, C.-C. C., Smalling, R., Davis, B., Habib, G., & Roberts, R.
- Venue
- Circulation
- Published
- 1999-04-06
- Volume
- 99
- Issue
- 13
- Pages
- 1671-1677
- ISSN
- 0009-7322 (ISSN-L)
- 1524-4539
- OpenAlex
- W2109813564
- Cited by
- 295
- References
- 14
- FWCI
- 17.88
- Type
- journal article
- Language
- en
- Open access
- bronze
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