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Exclusion of Acute Myocardial Infarction. The Value of Measuring Creatine Kinase Slope

Exclusion of Acute Myocardial Infarction. The Value of Measuring Creatine Kinase Slope Introduction Rapid diagnosis in patients admitted to the hospital shortly after onset of acute chest pain suggestive for myocardial ischaemia is important for clinical decision making. Appropriate treatment will be started if, based on the patient's history and initial electrocardiographic recordings, substantial evidence exists for an acute coronary event, whether unstable angina or evolving acute myocardial infarction. However, in a considerable number of patients with myocardial infarction the initial electrocardiogram is inconclusive or normal (1, 2). ) Enzyme: Creatine kinase, EC 2.7.3.2. Moreover, electrocardiographic findings were reported to be variable in a substantial fraction of patients with myocardial infarction (3). Therefore, measuring the activity concentration of creatine kinase1) (creatine kinase; EC 2.7.3.2) and its MB-isoenzyme, which reflect myocardial cell damage, has become an important tool in establishing the definitive diagnosis of acute myocardial infarction, mainly because these enzymes can be measured rapidly with automated analyzers. Since the diagnostic value of single measurements of creatine kinase and creatine kinase-MB activity concentration is limited (4--8), serial samples need to be measured. To provide Bakker et al.: Excluding myocardial infarction: the value of creatine kinase slope measurements defined according to the criteria by the New York Heart Association (28). Admission electrocardiograms http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Clinical Chemistry and Laboratory Medicine de Gruyter

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Publisher
de Gruyter
Copyright
Copyright © 2009 Walter de Gruyter
ISSN
1434-6621
eISSN
1437-4331
DOI
10.1515/cclm.1995.33.6.351
Publisher site
See Article on Publisher Site

Abstract

Introduction Rapid diagnosis in patients admitted to the hospital shortly after onset of acute chest pain suggestive for myocardial ischaemia is important for clinical decision making. Appropriate treatment will be started if, based on the patient's history and initial electrocardiographic recordings, substantial evidence exists for an acute coronary event, whether unstable angina or evolving acute myocardial infarction. However, in a considerable number of patients with myocardial infarction the initial electrocardiogram is inconclusive or normal (1, 2). ) Enzyme: Creatine kinase, EC 2.7.3.2. Moreover, electrocardiographic findings were reported to be variable in a substantial fraction of patients with myocardial infarction (3). Therefore, measuring the activity concentration of creatine kinase1) (creatine kinase; EC 2.7.3.2) and its MB-isoenzyme, which reflect myocardial cell damage, has become an important tool in establishing the definitive diagnosis of acute myocardial infarction, mainly because these enzymes can be measured rapidly with automated analyzers. Since the diagnostic value of single measurements of creatine kinase and creatine kinase-MB activity concentration is limited (4--8), serial samples need to be measured. To provide Bakker et al.: Excluding myocardial infarction: the value of creatine kinase slope measurements defined according to the criteria by the New York Heart Association (28). Admission electrocardiograms

Journal

Clinical Chemistry and Laboratory Medicinede Gruyter

Published: Jan 1, 1995

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