Circulation, Vol 61, 723-728, Copyright © 1980 by American Heart Association
P Grande, C Christiansen, A Pedersen and MS Christensen
The predictive value of a diagnostic test estimates the likelihood for
presence or absence of disease in a patient with a positive or negative
test result (PVpos or PVneg). We evaluated the predictive values of serum
activities of the heart-specific creatine kinase isoenzyme MB (CK- MB),
aspartate aminotransferase, lactate dehydrogenase, CK, and ECG in 401
consecutively admitted patients suspected of acute myocardial infarction
(AMI). The study showed that CK-MB (PVpos = 0.98, PVneg = 1.00) was better
than the other enzymes (single as well as serial) and ECG, evaluated both
separately and in combinations. In all cases of AMI CK-MB was positive
within 17 hours from admission. Replacement of the standard enzymes with
CK-MB provides a faster and safer diagnosis of AMI and reduces
hospitalization time considerably for patients without AMI.
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Optimal diagnosis in acute myocardial infarction. A cost-effectiveness study
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