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  • 1.
    Herlitz, Johan
    et al.
    [external].
    Svensson, L
    The value of biochemical markers for risk stratification prior to hospital admission in acute chest pain.2008In: Acute Cardiac Care, ISSN 1748-2941, E-ISSN 1748-295X, Vol. 10, no 4, p. 197-204Article in journal (Refereed)
    Abstract [en]

    We describe the use of biochemical markers in the pre-hospital setting with regard to diagnostic accuracy for the detection of an acute myocardial infarction (AMI) and for prognosis in connection with acute chest pain. The sensitivity has been reported to be limited; blood sampling occurs very early and often prior to the release of biochemical markers into the circulation. The specificity was in some studies also limited, but this is more difficult to explain. New biochemical markers like human heart fatty acid binding protein (H-FACB) have shown improved diagnostic accuracy, in the pre-hospital setting, in one small pilot study compared with traditional biochemical markers like troponins, creatine kinase (CK-MB) and myoglobin. However, in a recent small study, the sensitivity for troponin I (when a low decision limit for myocardial damage was used), when analysed prior to hospital admission, was reported to be very high. The latter data need to be confirmed in larger studies and various biochemical markers reflecting various pathophysiological aspects of the disease need to be tested before the analysis of any marker can be recommended for use in the pre-hospital setting of a suspected AMI

  • 2.
    Herlitz, Johan
    et al.
    University of Borås, School of Health Science.
    Svensson, Leif
    The value of biochemical markers for risk stratification prior to hospital admission in acute chest pain2008In: Acute Cardiac Care, ISSN 1748-2941, E-ISSN 1748-295X, Vol. 10, no 4, p. 197-204Article in journal (Refereed)
    Abstract [en]

    We describe the use of biochemical markers in the pre-hospital setting with regard to diagnostic accuracy for the detection of an acute myocardial infarction (AMI) and for prognosis in connection with acute chest pain. The sensitivity has been reported to be limited; blood sampling occurs very early and often prior to the release of biochemical markers into the circulation. The specificity was in some studies also limited, but this is more difficult to explain. New biochemical markers like human heart fatty acid binding protein (H-FACB) have shown improved diagnostic accuracy, in the pre-hospital setting, in one small pilot study compared with traditional biochemical markers like troponins, creatine kinase (CK-MB) and myoglobin. However, in a recent small study, the sensitivity for troponin I (when a low decision limit for myocardial damage was used), when analysed prior to hospital admission, was reported to be very high. The latter data need to be confirmed in larger studies and various biochemical markers reflecting various pathophysiological aspects of the disease need to be tested before the analysis of any marker can be recommended for use in the pre-hospital setting of a suspected AMI.

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