title: [Markers of myocardial damage in the diagnosis of acute myocardial infarction: the Italian reality in the year 2000].
abstract: BACKGROUND
  The Joint European Society of Cardiology and the American College of Cardiology Committee has recently reviewed the criteria to diagnose myocardial infarction, focusing on the central role of biochemical criterium and indicating the cardiac troponins as the reference marker. However, at present, little is known upon how "old" and "new" biochemical markers of myocardial damage are utilized in daily clinical practice.
  
  
  METHODS
  We performed a survey across the whole set of Italian coronary care units (CCUs) to evaluate the actual behavior of the clinicians in detecting myocardial necrosis with the biomarkers. A simple and brief questionnaire was used to pursue such purpose.
  
  
  RESULTS
  The feedback from CCUs was positive in 87.6% (303/346). The creatine kinase-MB is the most frequently used biomarker, however the "mass concentration" method was utilized in a minority of centers (38%). More than 60% of the CCUs are still measuring obsolete biomarkers as lactic dehydrogenase or aspartate transaminase. Cardiac troponins are measured only in 70% of the centers, and almost always in conjunction with the "old" biomarkers. Additionally, 14.5% of the Italian CCUs had written guidelines upon how to use the biomarkers to pose diagnosis of myocardial infarction. Biochemical criteria widely differed from center to center, regardless of the biomarker selected as reference standard.
  
  
  CONCLUSIONS
  The results of our survey show a high degree of difference in the choice as well as in the application criteria of biochemical markers for diagnosing myocardial infarction among the Italian CCUs. A great deal of confusion has been accumulating over the years among Italian cardiologists, and this situation was antecedent to the recently released revised criteria for detecting myocardial necrosis.
authors.affiliation: Divisione di Cardiologia, Ospedale Civile, Bentivoglio, BO. ottanif@omf.dsnet.it
authors.forename: Filippo
authors.initials: F
authors.lastname: Ottani
authors.forename: Marcello
authors.initials: M
authors.lastname: Galvani
authors.forename: Alberto
authors.initials: A
authors.lastname: Dolci
authors.forename: Mario
authors.initials: M
authors.lastname: Plebani
authors.forename: Marco
authors.initials: M
authors.lastname: Tubaro
authors.forename: Martina
authors.initials: M
authors.lastname: Zaninotto
authors.forename: Mauro
authors.initials: M
authors.lastname: Panteghini
mesh_terms: D015415:Biomarkers / Q000097:blood; D003325:Coronary Care Units; D006801:Humans; D007558:Italy; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis*; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers