Author + information
- Christina Dookhan,
- Abhijit Ghatak,
- Alejandro Mantero,
- Eduardo De Marchena,
- Ravi A. Patel,
- Cesar Mendoza and
- Alexandre Ferreira
Background: The non-guideline practice of obtaining serum cardiac enzyme levels prior to diagnosing ST Elevation Myocardial Infarction (STEMI) particularly when the diagnosis of STEMI may present challenging is not uncommonly seen. We compared the rates of false versus true STEMI activations among patients who had Point Of Care (POC) serum troponin testing performed prior to activation of Cardiac Catheterization Laboratory (CCL) at our institution.
Methods: The medical records of consecutive patients presenting for possible STEMI from July 2012 to November 2014 were reviewed. A false STEMI was defined as an absence of clinical and electrocardiographic evidence of ongoing myocardial infarction. Patients who lacked a visible culprit lesion on coronary angiogram corresponding to the location of ECG changes were also included as false STEMI. The percentages of False and True STEMI activations in patients with POC troponin done prior to CCL activation were compared using χ2 test. The median POC troponin levels in each group were compared using the student T test.
Results: Obtaining POC troponin levels prior to STEMI activation was associated with a higher rate of false STEMI activation: 21.4% (33/154)versus 11.1% (32/288), p 0.004. Median POC cardiac troponin T was significantly higher in the true STEMI cohort (0.41 ng/ml vs 0.015 ng/ml, p 0.004).
Conclusions: There was a significantly higher false STEMI activation rate when POC troponin was used to guide STEMI activation.
Poster Hall, Hall C
Saturday, March 18, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Acute Coronary Syndromes, Diagnosis, Management and Outcomes
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1253-342
- 2017 American College of Cardiology Foundation