ST elevation myocardial infarction laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Overview

A new clinical evidence based classification system has been jointly introduced by the American College of Cardiology (ACC), American Heart Association (AHA), European Society of Cardiology (ESC), and the World Heart Federation (WHF). The primary diagnostic tests include the electrocardiogram (ECG, EKG) and blood tests to detect elevated creatine kinase or troponin levels (these are chemical markers released by damaged tissues, especially the myocardium).

Four strategies for using troponin levels to diagnose acute myocardial infarction

Strategy	Proportion of patients meeting criteria	Sensitivity
Limit of detection (hs-cTnI<2 ng/L)	16%	100%
Single cutoff (hs-cTnI<5 ng/L)	54%	97%*
1-hour algorithm (hs-cTnI<5 ng/L and 1-hour change<2 ng/L)	52%	98%
0/1-hour (hs-cTnI < limit of detection and 1-hour change<2 ng/L) (European Society of Cardiology guideline).	52%	98%
* Drops to 94% among patients who present within 2 hours of onset of chest pain.