Myoglobin, creatine kinase MB, troponin T, and troponin I - rapid bedside assays in patients with acute chest pain

Three new rapid, qualitative bedside immunoassays were evaluated in the dia gnosis of patients with acute chest pain. The subjects, 122 patients in gro up 1 (bedside tests for myoglobin, creatine kinase MB) and 233 patients in group 2 (bedside tests for troponin I and sensitive troponin T) were admitt ed to hospital with acute chest pain for less than 12 h. The bedside tests were performed on admission, and 2, 4, and 6 h later. The correlation betwe en the two parts of the rapid creatine kinase MB/myoglobin test during the first 12 h after the onset of chest pain was moderate in all patients (kapp a=0.401, 95% confidence interval 0.321-0.483). The highest correlation was seen with the patients with definite and probable myocardial infarction. Th e correlations were smaller but significant also in other diagnostic groups (unstable angina pectoris, prolonged chest pain, and non-cardiac chest pai n). The correlation between the rapid sensitive test for troponin T and rap id test for troponin I was significant in all groups (kappa=0.776, 95% conf idence interval 0.711-0.841). The myoglobin part of the rapid creatine kina se MB/myoglobin test may be too non-specific for clinical diagnostic purpos es [in noninfarct patients the myoglobin part was significantly more often positive than creatine kinase MB or troponin tests (P<0.001)].