SERIAL MEASUREMENTS OF CARDIAC MARKERS TO RULE IN OR OUT ACUTE MYOCARDIAL DAMAGE LESS-THAN 3 H AFTER ADMISSION IN ACUTE CHEST PAIN PATIENTSWITHOUT ECG-SIGNS OF ACUTE MYOCARDIAL-INFARCTION

Acute chest pain patients without EGG-signs of acute myocardial infarc tion (AMI) on admission need to be earlier and better diagnosed to red uce use of expensive intensive care beds and to treat more patients wi th acute recirculation therapy. We investigated whether total CK-activ ity, CK-MB mass, CK-MB2, myoglobin, cardiac troponin I (cTnI) and T (c TnT) measured in venous blood on admission and after 1 and 2 h could b e used to identify or exclude acute myocardial damage (AMD) in 22 acut e chest pain patients without EGG-signs of AMI admitted to hospital wi thin 6 h after onset of pain. Increases in CK-MB mass, CK-MB2, myoglob in and cTnI identified AMD in three patients classified retrospectivel y as AMI. Likewise, CK-MB mass, CK-MB2, cTnI and cTnT increased with t ime in three of seven patients classified as having unstable angina pe ctoris. CK-MB2 and cTnI increased with time in two patients with tachy cardia belonging to the other heart disease group. The remaining seven patients of the non-heart disease group showed no change in any of th e cardiac markers. Thus, early serial measurements of selected cardiac markers appear useful in identifying or excluding AMD 3 h after admis sion in these acute chest pain patients.