title: Retrospective review: the incidence of non-ST segment elevation MI in emergency department patients presenting with decompensated heart failure.
abstract: The authors performed a 6-month review of heart failure patients presenting to a teaching hospital emergency department to determine the rate of positive serum myocardial infarction markers. All patients with an emergency department discharge diagnosis of heart failure were included; those with a creatinine level >2.0 mg/dL were excluded. There were 151 patients who met the entry criteria, with a mean age of 68.6 +/- 13.6 years, and 84 (56%) were men. The mean ejection fraction was 32%, and the mean Framingham score was 3.8 +/- 1.6. Twenty (14%) had positive markers. Troponin T was positive in 17 (11%), and creatine kinase was positive in nine (6%). Both markers were positive in six (4%). Chest pain was absent in 70% of the positive marker group. The authors conclude that elevated cardiac markers are not rare in decompensated heart failure. These pilot data suggest these tests should be routinely obtained on heart failure patients.
authors.affiliation: Department of Emergency Medicine, The Cleveland Clinic Foundation, Cleveland, OH 44195, USA. peacocw@ccf.org
authors.forename: W Frank
authors.initials: WF
authors.lastname: Peacock
authors.forename: Charles E
authors.initials: CE
authors.lastname: Emerman
authors.forename: Mohamad
authors.initials: M
authors.lastname: Doleh
authors.forename: Kimberly
authors.initials: K
authors.lastname: Civic
authors.forename: Saud
authors.initials: S
authors.lastname: Butt
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003402:Creatine Kinase / Q000097:blood; D052279:Creatine Kinase, MB Form; D003627:Data Interpretation, Statistical; D003936:Diagnosis, Computer-Assisted; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis*; D006801:Humans; D015994:Incidence; D007527:Isoenzymes / Q000097:blood; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000175:diagnosis*; D012189:Retrospective Studies; D013318:Stroke Volume / Q000502:physiology; D020107:Troponin T / Q000097:blood; D018487:Ventricular Dysfunction, Left / Q000097:blood / Q000175:diagnosis
chemical_list: D015415:Biomarkers; D007527:Isoenzymes; D020107:Troponin T; D003402:Creatine Kinase; D052279:Creatine Kinase, MB Form