Impact of the troponin standard on the prevalence of acute myocardial infarction

摘要: Abstract Background Recent recommendations are that troponin should replace creatine kinase (CK)-MB as the diagnostic standard for myocardial infarction (MI). The impact of this change has not been well described. Our objective was to determine a on prevalence acute non-ST–elevation MI. Methods current study retrospective analysis consecutive patients without ST-segment elevation admitted exclusion ischemia an inner city urban tertiary care center. All underwent serial marker sampling (CK, CK-MB, and cardiac I [cTnI]). Patients with ST consistent MI (n = 130) or who did have 8 hour cTnI 124) were excluded. 3 different values examined in 2181 patients: lower limit detectability (LLD); optimal value (OPT), chosen using receiver operator characteristic curve analysis; manufacturer's suggested upper reference level (URL), when compared gold CK-MB definition. In addition, assessed definitions evaluated ischemic changes only. Results 7.8%. Using various values, incidence increased by 28% 195%. cTnI, elevations meeting criteria had intermediate 30-day mortality (5.4%) those (7.1%). Grouping positive, negative rather than non-CK–MB reduced both (to 5.9%) non-MI groups (from 1.9% 1.6%). Conclusions Changing will substantial number diagnosed revised definition important clinical health implications.