[Usefulness of troponin T and troponin I in the diagnosis and prognostic stratification of patients with ischemic cardiopathy attending an emergency service].
BACKGROUND
Diagnostic of chest pain in the emergency services supposes a serious problem. This study wants objective if the new non enzymatic markers of myocardial necrosis (T troponin and I troponin) may be an aid for the diagnostic and prognostic stratification of patients with myocardial ischemia.


METHODS
82 successive patients who went to the emergency room for chest pain were studied. Electrocardiogram and blood samples were obtained at 0,4, and 12 house of admission. A clinic-evolutive study was performed at discharge, and they were classified in 3 categories: a) myocardial infarction, b) unstable angina (Braunwald classification) and no coronary pains.


RESULTS
In the 27 patients with myocardial infarction the markers of troponin group were more sensitive than creatinine kinase to determine myocardial necrosis at 4 hours of admission. Of 41 patients with unstable angina, 34% were of Braunwald III-B class. Troponin group markers discriminate a group of high risk patients, 70% of the patients that need an emergency coronarography for bad clinical evolution were troponin group marker positive.


CONCLUSIONS
The use in the emergency room of troponin necrosis markers (T and I troponin) allows to optimize the sanitary resources, detecting quickly the patients with acute myocardial infarction and discriminate a group of high risk of patients with angina.
Epelde
F
F
Servicio de Urgencias, Hospital Mútua de Terrassa, Barcelona.
Tomás
S
S
Argilaga
R
R
Martínez
X
X
Sáenz
L
L
D000368:Aged; D000369:Aged, 80 and over; D000789:Angina, Unstable / Q000097:blood / Q000145:classification / Q000175:diagnosis; D002637:Chest Pain / Q000097:blood / Q000145:classification / Q000175:diagnosis; D004796:Clinical Enzyme Tests; D003402:Creatine Kinase / Q000097:blood; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000145:classification / Q000175:diagnosis; D017202:Myocardial Ischemia / Q000097:blood / Q000175:diagnosis*; D011379:Prognosis; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors; D019210:Troponin I / Q000097:blood*; D020107:Troponin T / Q000097:blood*
D019210:Troponin I; D020107:Troponin T; D003402:Creatine Kinase
Utilidad de la troponina T y troponina I en el diagnóstico y estratificación pronóstica de los pacientes con cardiopatía isquémica que acuden a un Servicio de Urgencias.