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[Acute coronary syndrome without elevation of the ST segment: prognostic significance of determining the levels of troponin I and CPK-MBmass].

AIM
To assess diagnostic and prognostic role of CPK-MBmass and troponin I(TnI) in patients with acute coronary syndrome without persistent ST segment elevation (ACS).


MATERIAL AND METHODS
Standard laboratory and device tests, measurements of CPK-MBmass and TnI levels at admission, 12 and 24 hours after hospitalization were performed in 51 ACS patients (33 men, 18 women, mean age 63 +/- 8.2 years). Early and late (1 month and 6, 12 months after hospitalization, respectively) complications were studied.


RESULTS
The analysis of the immediate outcomes has revealed that treatment brought about stabilization of the condition in 45 (88.2%) patients, 6 patients had myocardial infarction within a month since the disease onset, one patient died. Late MI developed in 6 patients. For 6 months 2 more patients died. One patient died in the following 6 months. Thus ACS points to adverse 1-month prognosis in 12 and 1-year prognosis in 23.5% patients. TnI levels and CPK-MBmass are sensitive and specific for an adverse outcome in 91.7 and 100%, 82 and 89.7%, respectively. A predictive value for positive outcomes was 61.1 and 75%, respectively, for negative results 96.9 and 100%, respectively.


CONCLUSION
Estimation of CPK-MBmass and TnI is essential in diagnosis of non-Q-wave MI and is predictable in relation to both short- and long-term prognosis.