PMID: 9193972May 1, 1997Paper

Evaluation of a paired creatine kinase test for the diagnosis of acute myocardial infarction in patients with a non-diagnostic electrocardiogram

Journal of Accident & Emergency Medicine
A D HingoraniT H Foley

Abstract

The rate of rise of total plasma creatine kinase (CK) activity in the first 12 hours from presentation can be used to diagnose acute myocardial infarction. The aim of this study was to evaluate the performance of an abbreviated form of this test in the diagnosis of acute myocardial infarction in patients in whom the initial electrocardiogram was inconclusive. Using a protocol that requires only two CK measurements (separated by four hours) to estimate the rate of rise, the performance of the test was investigated using data accrued from 345 consecutive admissions with suspected acute myocardial infarction. A CK increment (delta CK) of > 20% in the first four hours from presentation had a diagnostic sensitivity of 84.4% (95% confidence interval 75.5 to 93.3), specificity of 85.8% (80.1 to 91.5), positive predictive accuracy of 73.0% (62.9 to 83.1), and negative predictive accuracy of 92.4% (87.9 to 96.9). Using more stringent diagnostic criteria (delta CK > 20% and 4 h CK value > 160 U/litre) resulted in an increase in specificity and positive predictive accuracy to 96.5% and 91.1% respectively, and a small reduction in sensitivity and negative predictive accuracy to 79.7% and 91.3%, respectively, 94% of all infarcts were correc...Continue Reading

References

Jul 1, 1988·Annals of Clinical Biochemistry·P O CollinsonT Evans
Aug 1, 1984·The American Journal of Cardiology·H BlankeK P Rentrop
Jan 1, 1994·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·J W HoekstraR A Christensen
Jan 1, 1994·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·J R HedgesJ R Swanson
Jun 11, 1994·BMJ : British Medical Journal·D G Altman, J M Bland
Jul 9, 1994·BMJ : British Medical Journal·D G Altman, J M Bland
Jul 16, 1994·BMJ : British Medical Journal·D G Altman, J M Bland
Jul 1, 1993·Annals of Clinical Biochemistry·J D JohnstonS B Rosalki
Jan 1, 1993·Annals of Clinical Biochemistry·P O CollinsonG D Carter

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Citations

Dec 31, 1997·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·L G Graff
Apr 20, 2001·Emergency Medicine Journal : EMJ·A M HuggonS Swaminathan
Jul 2, 2020·Journal of the Science of Food and Agriculture·Haiyan WeiAbraham Allan Degen

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