Creatine Kinase

CK-MB measurements are traditionally obtained early in the ED course of a patient admitted to the hospital for suspected AMI or ACI (79-82). The utility of the assay in the ED as a one-time test is limited because levels do not significantly increase until 4-6 h after the onset of AMI (79). In a meta-analysis of 10 studies of 2504 ED patients, the presenting CK-MB had a sensitivity of only 44% (95% CI: 35-53%), but a specificity of 96% (95% CI: 94-97%) (6). Serial CK-MB performs significantly better. In a metaanalysis of seven studies of 3229 ED patients, the sensitivity of serial CK-MB meas-

Table 8

Goldman Chest Pain Protocol

Table 8

Goldman Chest Pain Protocol

ED diagnostic performance

ED clinical impact

Quality

Accuracy

Quality

evidence

(max = + + +)

of evidence Impact

Was this article helpful?

0 0
Your Heart and Nutrition

Your Heart and Nutrition

Prevention is better than a cure. Learn how to cherish your heart by taking the necessary means to keep it pumping healthily and steadily through your life.

Get My Free Ebook


Post a comment