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Can We Exclude the Diagnosis of Non-ST Segment Myocardial Infarction on the Basis of a Single Troponin I and a Symptom Duration ≥8 Hours?
Background. The use of a single troponin measurement to exclude the diagnosis of non-ST segment myocardial infarction (NSTEMI) in patients that present with ischemic symptom duration ≥8 hours is sometimes used in the Emergency Department. Study Objective. To describe the characteristics of patients...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
International Scholarly Research Network
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262496/ https://www.ncbi.nlm.nih.gov/pubmed/22347640 http://dx.doi.org/10.5402/2011/364728 |
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author | Lynn, Jeremy S. Singh, Amandeep Snoey, Eric R. |
author_facet | Lynn, Jeremy S. Singh, Amandeep Snoey, Eric R. |
author_sort | Lynn, Jeremy S. |
collection | PubMed |
description | Background. The use of a single troponin measurement to exclude the diagnosis of non-ST segment myocardial infarction (NSTEMI) in patients that present with ischemic symptom duration ≥8 hours is sometimes used in the Emergency Department. Study Objective. To describe the characteristics of patients with initial nondiagnostic troponin values who develop a positive troponin while in the Emergency Department and to evaluate whether NSTEMI can be excluded using symptom duration ≥8 hours and initial troponin I. Methods. Retrospective chart review of patients evaluated for NSTEMI in the Emergency Department. Results. 4,510 patients had at least two troponin I values obtained during the two-year study period. 115 (2.5%) of these patients had an initially nondiagnostic (<0.6 ng/mL) and subsequent positive (≥0.6 ng/mL) troponin I result. Twenty-five (22%) of the 115 had duration of symptoms ≥8 hours. Of these 25 patients, 18 had an intermediate first troponin value (i.e., >0.06 ng/mL, but <0.6 ng/mL). Only two of the remaining seven patients had a final primary diagnosis of NSTEMI. Conclusion. The use of a negative initial troponin I together with a symptom onset of ≥8 hours defines a population with a very low incidence of a hospital diagnosis of NSTEMI. |
format | Online Article Text |
id | pubmed-3262496 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | International Scholarly Research Network |
record_format | MEDLINE/PubMed |
spelling | pubmed-32624962012-02-16 Can We Exclude the Diagnosis of Non-ST Segment Myocardial Infarction on the Basis of a Single Troponin I and a Symptom Duration ≥8 Hours? Lynn, Jeremy S. Singh, Amandeep Snoey, Eric R. ISRN Cardiol Research Article Background. The use of a single troponin measurement to exclude the diagnosis of non-ST segment myocardial infarction (NSTEMI) in patients that present with ischemic symptom duration ≥8 hours is sometimes used in the Emergency Department. Study Objective. To describe the characteristics of patients with initial nondiagnostic troponin values who develop a positive troponin while in the Emergency Department and to evaluate whether NSTEMI can be excluded using symptom duration ≥8 hours and initial troponin I. Methods. Retrospective chart review of patients evaluated for NSTEMI in the Emergency Department. Results. 4,510 patients had at least two troponin I values obtained during the two-year study period. 115 (2.5%) of these patients had an initially nondiagnostic (<0.6 ng/mL) and subsequent positive (≥0.6 ng/mL) troponin I result. Twenty-five (22%) of the 115 had duration of symptoms ≥8 hours. Of these 25 patients, 18 had an intermediate first troponin value (i.e., >0.06 ng/mL, but <0.6 ng/mL). Only two of the remaining seven patients had a final primary diagnosis of NSTEMI. Conclusion. The use of a negative initial troponin I together with a symptom onset of ≥8 hours defines a population with a very low incidence of a hospital diagnosis of NSTEMI. International Scholarly Research Network 2011 2011-04-12 /pmc/articles/PMC3262496/ /pubmed/22347640 http://dx.doi.org/10.5402/2011/364728 Text en Copyright © 2011 Jeremy S. Lynn et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Article Lynn, Jeremy S. Singh, Amandeep Snoey, Eric R. Can We Exclude the Diagnosis of Non-ST Segment Myocardial Infarction on the Basis of a Single Troponin I and a Symptom Duration ≥8 Hours? |
title | Can We Exclude the Diagnosis of Non-ST Segment Myocardial Infarction on the Basis of a Single Troponin I and a Symptom Duration ≥8 Hours? |
title_full | Can We Exclude the Diagnosis of Non-ST Segment Myocardial Infarction on the Basis of a Single Troponin I and a Symptom Duration ≥8 Hours? |
title_fullStr | Can We Exclude the Diagnosis of Non-ST Segment Myocardial Infarction on the Basis of a Single Troponin I and a Symptom Duration ≥8 Hours? |
title_full_unstemmed | Can We Exclude the Diagnosis of Non-ST Segment Myocardial Infarction on the Basis of a Single Troponin I and a Symptom Duration ≥8 Hours? |
title_short | Can We Exclude the Diagnosis of Non-ST Segment Myocardial Infarction on the Basis of a Single Troponin I and a Symptom Duration ≥8 Hours? |
title_sort | can we exclude the diagnosis of non-st segment myocardial infarction on the basis of a single troponin i and a symptom duration ≥8 hours? |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3262496/ https://www.ncbi.nlm.nih.gov/pubmed/22347640 http://dx.doi.org/10.5402/2011/364728 |
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