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Fırat Tıp Dergisi
2006, Cilt 11, Sayı 2, Sayfa(lar) 103-107
[ Turkish ] [ Tam Metin ] [ PDF ]
Value of Myoglobin, Troponin T and CK-MB in the Early Diagnosis of Acute Myocardial Infarction
Yemliha AKSOY1, Ali ERGİN2, M. Erdoğan SÖZÜER1, İbrahim İKİZCELİ1, Levent AVŞAROĞULLARI1, Cuma YILDIRIM3
1Erciyes Üniversitesi Tıp Fakültesi, Acil Tıp Anabilim Dalı, GAZİANTEP
2Erciyes Üniversitesi Tıp Fakültesi, Kardiyoloji Anabilim Dalı, KAYSERİ
3Gaziantep Üniversitesi Tıp Fakültesi, Acil Tıp Anabilim Dalı, GAZİANTEP

Objectives: Substantial portion of patients with chest pain, who arrive to the emergency department, are diagnosed as acute coronary syndrome. Early diagnosis and timely administration of trombolytic agents decrease mortality and morbidity, shorten stay period of the patients at the hospital, and affect prognosis of the disease positively. In the patients with atypical chest pain and nondiagnostic ECG's, markers which are highly sensitive and exclusive in early period are needed for early and accurate diagnosis of AMI. We compared myoglobin and troponin T with CK-MB that is used routinely in the practice to determine their early ruling out and ruling in of AMI.

Materials and Methods: Sixty two patients with chest pain presenting to the emergency department were included in the study. Of the patients (n=62) 30 had diagnosis of MI. The remaining 32 patients had diagnosis of UA and nonspesific chest pain. The patients whose clinical conditions may cause false-positive results of marker assays were excluded from the study. At the 2nd, 3th, 4th, 5th, 6th and 12th hours of begining the ches pain, blood were taken for myoglobin, troponin and CK-MB analyses.

Results: Sensitivities of myoglobin, troponin T, and CK-MB were 53%, 3%, and 0% respectively. At the same time their NPD's were 68 %, 52 %, and 51 % respectively. In the 5th hour after the onset of chest pain the sensitivities were 100 %, 93 %, and 76 % respectively. In the same time the NPD's were 100 %, 94 %, and 81 %. As a result, myoglobin was found out to be the most sensitive and exclusive marker in early period for diagnosis of AMI. Troponin T was determined as a later sensitive and exclusive marker in diagnosis of AMI.

Conclusion: It can be concluded that additional use of CK-MB concurrent measurement of myoglobin, a cardiosensitive marker, and troponin T, a cardiospesific marker, in blood may be an appropriate strategy for early diagnosis of AMI.©2006, Fırat Üniversitesi, Tıp Fakültesi


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