PMID- 10958863
OWN - NLM
STAT- MEDLINE
DCOM- 20001010
LR  - 20190706
IS  - 0009-8981 (Print)
IS  - 0009-8981 (Linking)
VI  - 300
IP  - 1-2
DP  - 2000 Oct
TI  - CK-MB isoforms for early risk stratification of emergency department patients.
PG  - 57-73
AB  - The potential clinical utility of single sample CK-MB isoforms measurement for 
      early risk stratification of Emergency Department (ED) patients with possible 
      myocardial ischemia was evaluated among 405 patients presenting to two urban EDs. 
      Clinical and serologic data were prospectively collected and the occurrence of 
      adverse events (AEs) and myocardial infarction (MI) during the 14-day outcome 
      period was recorded and utilized to calculate and compare relative risks (RR) and 
      predictive values of isoforms and CK-MB alone. Among the 405 patients, 67 accrued 
      105 AEs. Both isoforms and CK-MB alone were predictive of AEs with RR of 3.32 
      (2.09, 5.27) and 6.28 (4.64, 8.52), respectively. Isoforms had higher sensitivity 
      for AEs compared to CK-MB (65.7% [54.3, 77.0] vs. 14.9% [6.4, 23.5]; p<0. 01) but 
      lower specificity (69.2% [64.3, 74.2] vs. 99.7% [99.1,100. 0]; p<0.01). Isoforms' 
      superior sensitivity allowed identification of many high risk patients missed by 
      CK-MB alone. Further, for the prediction of MI, isoforms had superior diagnostic 
      sensitivity and equivalent specificity. This investigation supports the emergency 
      department use of early, single sample CK-MB isoform testing.
FAU - Green, G B
AU  - Green GB
AD  - Department of Emergency Medicine, The Johns Hopkins University School of 
      Medicine, Baltimore, MD, USA. ggreen@jhmi.edu
FAU - Dehlinger, E
AU  - Dehlinger E
FAU - McGrievey, T S
AU  - McGrievey TS
FAU - Li, D J
AU  - Li DJ
FAU - Jones, K A
AU  - Jones KA
FAU - Kelen, G D
AU  - Kelen GD
FAU - Chan, D W
AU  - Chan DW
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - Netherlands
TA  - Clin Chim Acta
JT  - Clinica chimica acta; international journal of clinical chemistry
JID - 1302422
RN  - 0 (Isoenzymes)
RN  - EC 2.7.3.2 (Creatine Kinase)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Algorithms
MH  - Creatine Kinase/*blood
MH  - *Emergency Service, Hospital
MH  - Female
MH  - Humans
MH  - Isoenzymes
MH  - Male
MH  - Middle Aged
MH  - Myocardial Ischemia/diagnosis/enzymology
MH  - Prospective Studies
MH  - Sensitivity and Specificity
MH  - Triage/*methods
EDAT- 2000/08/26 11:00
MHDA- 2000/10/14 11:01
CRDT- 2000/08/26 11:00
PHST- 2000/08/26 11:00 [pubmed]
PHST- 2000/10/14 11:01 [medline]
PHST- 2000/08/26 11:00 [entrez]
AID - S0009-8981(00)90295-X [pii]
AID - 10.1016/s0009-8981(00)90295-x [doi]
PST - ppublish
SO  - Clin Chim Acta. 2000 Oct;300(1-2):57-73. doi: 10.1016/s0009-8981(00)90295-x.