EVALUATION OF MARKERS OF MYOCARDIAL INJURY REQUESTED IN A HOSPITAL AT SÃO PAULO, BRAZIL

Abstract

The evaluation of biochemical markers of myocardial necrosis is essential to the early diagnosis of acute myocardial infarction and to ensure a better patient prognosis. However, each marker has a profile that should suit the characteristics of clinical presentation that is being evaluated. So, the objective of the present study was to determine the profile of serum cardiac markers requested in the clinical laboratory of Heliopolis Hospital, and discuss the implications of such choices. By verifying the laboratory results maps, it was made a survey of biochemical markers of myocardial injury required in a period of three months, from patients admitted to the emergency department with symptoms suggestive of ischemic cardiac event. Among 2242 exams from 1084 patients, 47% were for total CK, 43% for CK-MB and 10% to troponins, with no requests of myoglobin dosage during the study period. Of the total number of tests ordered and changed, most refers to male patients. This study suggests that at the time of patient admission to the emergency department, a combination of myoglobin and a more specific marker of myocardial necrosis (CK-MB) should be requested to the early exclusion of a myocardial infarction. It would be, in addiction to effective to the diagnosis, more financially viable. In this context, a special attention should be given to women treated with ischemic symptoms, considering the high mortality rates associated to them.