급성심근경색 진단에서 CK-MB, troponin-T의 시간에 따른 진단의 유용성

Abstract

Purpose: In patient presenting at emergency department with chest pain, we have to diagnosis whether acute myocardial infarction(AMI) or not. Because earlier diagnosis gives better prognosis to patient, if AMI is diagnosed late, the appropriate care will not be done. And then, that result in poor prognosis. The cardiac enzymes like CK-MB and troponin-T, are useful diagnosis tools of AMI. Those two cardiac enzymes are elevated in several hours after chest pain begin. If we know exact time of elevating of cardiac enzyme, we will be able to give appropriate care to AMI patients. This study was performed to know usefulness of both cardiac enzyme(CK-MB, Troponin) and necessity of both cardiac enzyme(CK-MB, Troponin) serum test to confirm AMI. Methods: One hundred thirty three patients with AMI visited an emergency center from July 2006 to June 2008. And we exclude 39 patients who were arrive at emergency center 24 hours after chest pain begin. We were studied retrospectively. We checked cardiac enzymes at 3 hour, 6 hour, 12 hour and 24 hour after chest pain begin. And then, we compared CK-MB with troponin-T about elevation time after chest pain. Results: The elevation time of CK-MB and troponin-T after chest pain is not related with age, sex, high risk factor and ST segment elevation. Measuring CK-MB and troponin-T was performed, we can see CK-MB and troponin-T elevation rate at 6 hour after chest pain are significantly higher than those of 3 hour(both p-value 0.000). But, above positive numerical value of CK-MB is elevated faster than that of troponin -T.(67.2% , 59.7% respectively at 6hour after chest pain onset). Conclusion: CK-MB and troponin-T are cardiac marker to diagnose AMI. Although, troponin was known more specific marker than CK-MB, CK-MB elevate faster than troponin-T after chest pain begin. To diagnose AMI as soon as possible, the measurement of CK-MB is more useful than troponin-T and serial check of CK-MB is important. Key words: Acute myocardial infarction, CK-MB, Troponin-T