بررسی مقایسه ای روش های آزمون سریع و روتین در سنجش نشانگرهای قلبی در بیماران مشکوک به حمله قلبی حاد

Background : In many patients with chest pain, the correct diagnosis of acute myocardial infarction(AMI) is dependent mainly on the measurement of cardiac markers such as cardiac creatin kinase isoenzyme (CK-MB) and cardiac troponin I (cTnI) ,because the electrocardiogram is often non-diagnostic. The measurement of cardiac markers are superior for the detection of minor myocardial injury and more-accurative diagnosis. The purpose of this study was to evaluate the assay of routin method of CK-MB and cTnI in comparison with rapid test method in suspected patients to AMI. Materials and Methods: The study population comprised 142 patients admitted to the emergency ward with acute chest pain for less than 12 hours before admission. Venous blood specimen were obtained to measure CK-MB and cTnI rapid assay tests with Acon and Golden kits, and Elisa cTnI and photometry CK-MB assays. Results: The results of Elisa cTnI assay had 52 positive and 90 negative patients compared to Golden cTnI rapid test, 27 positive and 110 negative patients, while in comparison with Acon cTnI rapid test there were 30 positive and 112 negative patients ( p≤ 0.001). The results of photometry CK-MB assay had 39 positive and 103 negative patients compared to Golden CK-MB rapid test which had 60 positive and 77 negative patients( p ≤ 0.001), while in comparison with Acon CK-MB rapid test in had 78 positive and 64 negative patients ( p ≤ 0.035). Relative sensitivity and relative specificity were compared to routne metohs: for the Golden rapid cTnI test were 50% and 98.8% respectively for Acon rapid cTnI test 51.9% and 96.6%, for Golden rapid CK-MB test 69.2%/ and 63.1°/o, and for Acon rapid CK-MB test 69.2% and 50.4% . Conclusion: The present results showed that the rapid cTnI test is very specific but not sensitive for AMI diagnosis while rapid CK-MB test is neither sensitive nor specific for AMI dignosis in patients with acute chest pain.