Abstract
Introduction
Cardiac biomarker measurement can aid diagnosis of acute myocardial infarction. The present study evaluates the efficacy and efficiency of point-of-care multimarkers measurement of myoglobin, creatine kinase (CK-MB) and troponin in identifying patients with acute myocardial infarction.
Method
We prospectively enrolled consecutive patients (N=105) in the emergency department who were being evaluated for possible acute myocardial infarction. Point-of-care testing (POCT) of myoglobin, CK-MB and troponin I (TnI) was performed in all patients. Central laboratory measurement of troponin I was also performed simultaneously. The sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and receiver operating characteristic (ROC) curve were evaluated.
Result
The specificity and positive likelihood ratio of TnI (POCT) and TnI (laboratory) were 98%, 13.0 and 98%, 21.8 respectively. The areas under curve of the ROC curve of TnI (POCT) and TnI (laboratory) were 0.692 and 0.725 respectively.
Conclusion
A high positive likelihood ratio for acute myocardial infarction through point-of-care testing can help timely diagnosis and just-in-time appropriate management for patients presenting with chest pain.