EXCELLENT RELIABILITY OF NURSE-BASED BEDSIDE DIAGNOSIS OF ACUTE MYOCARDIAL-INFARCTION BY RAPID DRY-STRIP CREATINE-KINASE MB, MYOGLOBIN, ANDTROPONIN-T

With the aim to compare the diagnostic efficacy as regards acute myoca rdial infarction of two rapid dry-strip tests, one with both creatine kinase MB (CK-MB) and myoglobin (C + M) and the other with troponin T, and to test the reliability of bedside diagnosis by the coronary care unit (CCU) nurse, 151 patients with acute chest pain admitted to the CCU were investigated. There was no difference in diagnostic performan ce between rapid tests and quantitative determinations. With <6-hour d uration of symptoms, the sensitivity was better for C + M than For tro ponin T (72% vs 33%, p<0.05). With symptoms lasting >12 hours on arriv al, troponin T performed better, with 100% sensitivity and a negative predictive value of 100% in the 6-hour retest. For exclusion of damage , the two tests have similar and reliable diagnostic capacities 12 hou rs after the onset of symptoms. The bedside diagnosis or exclusion of acute myocardial infarction was carried out rapidly (within 20 minutes ) and reliably by the CCU nurses.