Are Non-STEMI Patients with Discordant Cardiac Biomarkers Undertreated?

Patients with non–ST-segment-elevation myocardial infarction who are troponin positive and creatine kinase MB negative undergo fewer treatments and tests than patients who are positive for both markers.

In a review of records from a U.S. myocardial infarction (MI) registry from 2007 to 2008, researchers identified patients with non–ST-segment-elevation MI who had positive troponin tests, arrived directly at the treating institution, and did not have prior MI or revascularization, and compared treatment and outcomes between patients with negative peak creatine kinase MB (CKMB) tests and those with positive peak CKMB tests.

Of 16,064 patients identified, 28% were CKMB negative. CKMB-negative patients were significantly less likely than CKMB-positive patients to receive some guideline-recommended pharmacologic interventions (antithrombin agents, clopidogrel, and glycoprotein IIb/IIIa antagonists), to undergo some invasive investigations (coron…

Reviewing Author

J. Stephen Bohan, MD, MS, FACP, FACEP

Disclosures

RoyaltiesKlint Law Firm

Editorial boardsCritical Decisions in Emergency Medicine

J. Stephen Bohan, MD, MS, FACP, FACEP

Disclosures

RoyaltiesKlint Law Firm

Editorial boardsCritical Decisions in Emergency Medicine