[Total creatine kinase (CK), CK-2 and myoglobin in the diagnosis of acute myocardial infarct in an emergency service].
BACKGROUND
In situations with important limitation in the number of beds available the decision of whether to admit a patient with suspected myocardial infarction into a coronary unit is frequently based on certain laboratory tests.


METHODS
Two hundred sixty-five patients who went to the hospital for thoracic pain and those for whom the physician on duty requested serum creatinkinase (CK) determination were studied. In addition to total CK, CK-2 and myoglobin were determined in the initial serum sample. The diagnostic performance of these tests was compared with the clinical algorithm developed by Goldman et al to predict the probability of infarction.


RESULTS
The prevalence of infarction in the sample was 10%. The number of patients admitted to the ICU represented 26% of those who would have been admitted upon applying the standard criteria. The tests demonstrating the greatest area under the ROC the Goldman et al algorithm (0.78) and myoglobin (0.69). The sensitivity of the laboratory tests was too low to be used as a method of selection. The additional diagnostic information obtained from the myoglobin was of slight relevance when compared to that obtained from the clinical algorithm.


CONCLUSIONS
The diagnostic performance of the serum determinations of creatinkinase, creatinkinase-2 and myoglobin does not justify their use as method of patient selection.
Unidad de Cuidados Intensivos, Hospital General d'Elx, Alicante.
J
J
Latour Pérez
M
M
Alvarez do Barrio
M A
MA
Estellés Herrero
M L
ML
Graells Ferrer
D000328:Adult; D000368:Aged; D004796:Clinical Enzyme Tests / Q000706:statistics & numerical data; D003402:Creatine Kinase / Q000097:blood*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology; D009211:Myoglobin / Q000097:blood*; D016017:Odds Ratio; D011336:Probability; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013030:Spain / Q000453:epidemiology
D007527:Isoenzymes; D009211:Myoglobin; D003402:Creatine Kinase
La creatincinasa (CK) total, la CK-2 y la mioglobina en el diagnóstico de infarto agudo de miocardio en un servicio de urgencias.