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      Case Definitions for Acute Coronary Heart Disease in Epidemiology and Clinical Research Studies : A Statement From the AHA Council on Epidemiology and Prevention; AHA Statistics Committee; World Heart Federation Council on Epidemiology and Prevention; the European Society of Cardiology Working Group on Epidemiology and Prevention; Centers for Disease Control and Prevention; and the National Heart, Lung, and Blood Institute

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          Implementation of serum cardiac troponin I as marker for detection of acute myocardial infarction.

          The goal of this prospective study was to assess whether cardiac troponin I (cTnI) could replace creatine kinase (CK)-MB mass as the serum biochemical marker for detection of acute myocardial infarction (AMI). Over a 3-month period, 327 nonselected, consecutive patients were evaluated for AMI with the use of modified World Health Organization criteria including serial electrocardiographs and CK-MB mass determinations at admission and 6, 12, and 24 hours after admission. cTnI measurements were also made at all time points. Sixty-two (19%) patients were diagnosed with AMI. Diagnostic sensitivity and specificity for peak concentrations were equivalent or better for cTnI (100%; 96.3%) compared with CK-MB (88. 2%; 93.2%) and total CK (73.5%; 84.6%), respectively. cTnI demonstrated 100% negative predictive accuracy for ruling out AMI. Further, cTnI maintained a high diagnostic sensitivity (>94%) up to 96 hours after onset of chest pain compared with CK-MB and total CK (both 50% sensitive) in patients with AMI. However, patients with documented Q-wave infarctions had a significantly longer clearance compared with non-Q-wave infarctions (dagger(1/2) 24.2 vs 7.3 hours, respectively; P <.01). There was a significant (P <.02) positive correlation (r = 0.89) between increasing CK-MB mass and increasing cTnI for AMI specimens. These findings have strongly supported our clinical implementation of cTnI, replacing CK-MB mass as the preferred marker for detection of AMI.
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            Detection of unsuspected myocardial necrosis by rapid bedside assay for cardiac troponin T.

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              Author and article information

              Journal
              Circulation
              Circulation
              Ovid Technologies (Wolters Kluwer Health)
              0009-7322
              1524-4539
              November 18 2003
              November 18 2003
              : 108
              : 20
              : 2543-2549
              Article
              10.1161/01.CIR.0000100560.46946.EA
              14610011
              5b9bf8a2-415b-4cd2-b38a-624e939cd127
              © 2003
              History

              Molecular medicine,Neurosciences
              Molecular medicine, Neurosciences

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