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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...

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Autores principales: Lynn, Jeremy S., Singh, Amandeep, Snoey, Eric R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scholarly Research Network 2011
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.
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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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