Coronary Artery Disease and the Acute Coronary Syndrome
Authors: Tony J. DeMartini, Henry S. Loeb
Journal: Annals of Internal Medicine (2003)

Letters2 December 2003Coronary Artery Disease and the Acute Coronary SyndromeTony J. DeMartini, MD and Henry S. Loeb, MDTony J. DeMartini, MDFrom Hines Veterans Affairs Hospital, Hines, IL 60141.Search for more papers by this author and Henry S. Loeb, MDFrom Hines Veterans Affairs Hospital, Hines, IL 60141.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-139-11-200312020-00022-w1 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Coronary artery disease and the acute coronary syndrome are difficult to identify in patients with an atypical history. A complete history and physical examination, in addition to electrocardiography and measurement of serum cardiac enzymes, contribute to the accurate diagnosis of the disease.Cardiac enzymes used to identify myocardial damage have undergone an extensive transformation. In 1954, Karmen and colleagues used serum glutamic oxaloacetic aminotransferase and lactate dehydrogenase (LDH) as markers of myocardial infarction (1). Reliance on these enzymes is problematic because of low sensitivity and specificity. The sensitivity and specificity of the LDH isoenzymes increased when ...References1. Karmen A, Wroblewski F, LaDue JS. Transaminase activity in human blood. J Clin Invest. 1954;34:126-33. CrossrefGoogle Scholar2. Cohen L, Djordjevich J, Ormiste V. Serum lactic dehydrogenase isozyme patterns in cardiovascular and other diseases, with particular reference to acute myocardial infarction. J Lab Clin Med. 1964;64:355-62. MedlineGoogle Scholar3. Dreyfus JC, Schapira G, Resnais J, Scebat L. Le creatine-kinase serique dans le diagnostic de l'infarctus myocardique. Rev Fr Etud Clin Biol. 1960;5:386-90. MedlineGoogle Scholar4. Konttinen A, Sommer H. Determination of serum creatine kinase isoenzymes in myocardial infarction. Am J Cardiol. 1972;29:817-20. [PMID: 5033724] CrossrefMedlineGoogle Scholar5. Adams JE, Bodor GS, Davila-Roman VG, Delmez JA, Apple FS, Ladenson JH, . Cardiac troponin I. A marker with high specificity for cardiac injury. Circulation. 1993;88:101-6. [PMID: 8319322] CrossrefMedlineGoogle Scholar6. Krahn J, Parry DM, Leroux M, Damon J. High percentage of false positive cardiac troponin I results in patients with rheumatic factor. Clin Biochem. 1999;6:477-80. [PMID: 10667485] CrossrefMedlineGoogle Scholar7. Plebani M, Mion M, Altinier S, Girotto MA, Baldo G, Zaninotto M. False-positive troponin I attributed to a macrocomplex [Letter]. Clin Chem. 2002;48:677-9. [PMID: 11901077] CrossrefMedlineGoogle Scholar8. Knoblock RJ, Lehman CM, Smith RA, Apple FS, Roberts WL. False-positive AxSYM cardiac troponin I results in a 53-year-old woman. Arch Pathol Lab Med. 2002;126:606-9. [PMID: 11958670] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Hines Veterans Affairs Hospital, Hines, IL 60141. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byThe Causes and Outcomes of Inadequate Implementation of Existing Guidelines for Antiplatelet Treatment in Patients With Acute Coronary Syndrome: The Experience From Taiwan Acute Coronary Syndrome Descriptive Registry (T-ACCORD Registry) 2 December 2003Volume 139, Issue 11Page: W-82KeywordsAcute coronary syndromeAntibodiesCreatineEnzymesLactate dehydrogenaseMyocardial infarctionResearch laboratoriesSpecificityStable coronary artery diseaseTroponin ePublished: 2 December 2003 Issue Published: 2 December 2003 Copyright & PermissionsCopyright © 2003 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...