title: Myoglobin, creatine kinase MB, troponin T, and troponin I - rapid bedside assays in patients with acute chest pain.
abstract: Three new rapid, qualitative bedside immunoassays were evaluated in the diagnosis of patients with acute chest pain. The subjects, 122 patients in group 1 (bedside tests for myoglobin, creatine kinase MB) and 233 patients in group 2 (bedside tests for troponin I and sensitive troponin T) were admitted to hospital with acute chest pain for less than 12 h. The bedside tests were performed on admission, and 2, 4, and 6 h later. The correlation between the two parts of the rapid creatine kinase MB/myoglobin test during the first 12 h after the onset of chest pain was moderate in all patients (kappa=0.401, 95% confidence interval 0.321-0.483). The highest correlation was seen with the patients with definite and probable myocardial infarction. The correlations were smaller but significant also in other diagnostic groups (unstable angina pectoris, prolonged chest pain, and non-cardiac chest pain). The correlation between the rapid sensitive test for troponin T and rapid test for troponin I was significant in all groups (kappa=0.776, 95% confidence interval 0.711-0.841). The myoglobin part of the rapid creatine kinase MB/myoglobin test may be too non-specific for clinical diagnostic purposes [in non-infarct patients the myoglobin part was significantly more often positive than creatine kinase MB or troponin tests (P<0.001)].
authors.affiliation: Department of Clinical Chemistry, Kuopio University Hospital, FIN-70210 Kuopio, Finland.
authors.forename: K
authors.initials: K
authors.lastname: Penttilä
authors.forename: H
authors.initials: H
authors.lastname: Koukkunen
authors.forename: A
authors.initials: A
authors.lastname: Kemppainen
authors.forename: M
authors.initials: M
authors.lastname: Halinen
authors.forename: T
authors.initials: T
authors.lastname: Rantanen
authors.forename: K
authors.initials: K
authors.lastname: Pyörälä
authors.forename: I
authors.initials: I
authors.lastname: Penttilä
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002637:Chest Pain / Q000175:diagnosis*; D003402:Creatine Kinase / Q000097:blood*; D005069:Evaluation Studies as Topic; D005240:Feasibility Studies; D005260:Female; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007527:Isoenzymes; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology; D009211:Myoglobin / Q000097:blood*; D011237:Predictive Value of Tests; D011247:Pregnancy; D020033:Protein Isoforms / Q000097:blood*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013997:Time Factors; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D009211:Myoglobin; D020033:Protein Isoforms; D019210:Troponin I; D020107:Troponin T; D003402:Creatine Kinase