85: Use of panel assay of cardiac biomarkers in the detection and management of suspected acute myocardial infarction in the emergency department of Health Centre of Soxos

Conference: 
Author(s): 
M. Pape, A. Smagadi, I. Charitonidis
HEALTH CENTRE OF SOXOS, AHEPA UNIVERSITY HOSPITAL OF THESSALONIKI, THESSALONIKI, Greece
Text: 
Objective: To determine the feasibility of using cardiac biomarkers to identify patients with suspected acute myocardial infarction (AMI).
Methods: The study population consisted of 55 patients who presented with symptoms [T=sudden chest pain typically radiating to the left arm or left side of the neck (n=18) and A=shortness of breath, sweating, anxiety (n=37)] of possible cardiac cause. Each participant underwent a physical exam, including medical history [risk factors for myocardial infarction (RFMI): diabetes, hypertension, dyslipidaemia, smoking, obesity]. A 12-lead electrocardiogram (ECG) was recorded. Venus blood samples were drawn in heparinised tubes, 6 hours after symptoms onset, for cardiac biomarkers (CB) testing. We used a point-of-care-device for rapid estimation of myoglobin (Myo), creatinine kinase (CK-MB), and cardiac troponin (cn) (Triage Cardiac Panel). Patients were divided into groups based on the ECG findings: [non-diagnostic electrocardiogram (NDE), acute myocardial infarction or acute coronary ischaemia based on ST segment elevation or depression (AMI/ACI), arrhythmia (A), atrioventricular block (AV-B)] and on the cardiac assay results (CAR): [1=CK-MB+Myo+Tn (-), 2=Myo (+) ′ CKMB (+), 3= Myo+CKMB (+), 4=(CKMB+Myo+Tn (+)].
Results: The evaluated outcome measures after the initial clinical assessment, electrocardiography and laboratory analysis were as follows: admission in cardiology service using the emergency ambulance (ACS-EA) [symptoms (T) (n=9), symptoms (A) (n =12)], proposed admission in cardiology service for further cardiology evaluation (FCE) ) [symptoms (T) (n=4), symptoms (A) (n=2)], proposed examination of family doctor (EFD) [symptoms (T) (n=5), symptoms (A) (n=23)].
Conclusion: Cardiac biomarkers have a complementary role in the assessment of a suspected stroke patient.