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J Korean Soc Emerg Med > Volume 17(5); 2006 > Article
Journal of The Korean Society of Emergency Medicine 2006;17(5): 412-418.
The Value of Arterial Lactate for Diagnosis of Acute Myocardial Infarction at Emergency Department
Jae Kwan Lee, Ki Youl Kim, Yong Su Lim, Jin Joo Kim, Gun Lee, Hyuk Jun Yang, Seong Youn Hwang, Ji Ho Ryu
1Department of Emergency Medicine, Gil Hospital, Gachon University of Medicine, and Science, Incheon, Korea. yongem@gilhospital.com
2Department of Emergency Medicine, Masan Samsung Hospital, Sungkyunkwan University School of Medicine, Masan, Korea.
3Department of Emergency Medicine, Pusan University Hospital, Pusan, Korea.
Many methods have been employed for the diagnosis of acute myocardial infarction (AMI) in emergency departments (ED). However, there is still no definite screening marker for the early diagnosis of AMI, We studied arterial lactate as an inexpensive and simple potential screening marker for diagnosis of early onset AMI.
A retrospective study was performed on 369 patients who visited our ED for chest pain between September 2004 and August 2005. Arterial lactate was sampled and compared against traditional cardiac enzymes such as troponin I and CK-MB. We focused on 171 patients who visited the ED within 4 hours after their symptoms had developed, a time frame in which traditional cardiac enzyme tests usually give normal results.
The overall sensitivity of arterial lactate in the detection of AMI was 57.4%, and when tested within 4 hours after the development of symptoms its sensitivity was 63.9%. Sensitivity of testing with troponin I and CK-MB, by contrast, was 42.6%. However, the combined overall sensitivity of detection using lactate, troponin I, and CK-MB for the diagnosis of AMI within 4 hours of first symptoms was 85.2%.
Arterial lactate alone was not particularly sensitive for the detection of AMI, but combination testing using lactate, troponin I, and CK-MB was highly sensitive for AMI.
Key words: Lactate, Myocardial infarction, Diagnosis
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