In message <[log in to unmask]>, Mohammad
Al-Jubouri <[log in to unmask]> writes
>Dear all
>I would welcome your views on timing of samples for a
>single TnI measurement for the assessment of acute
>coronary syndrome. Most laboratories have adopted 12 h
>post admission whether they measure TnI or TnT. If we
>are aiming at measuring peak troponin levels, which
>correlate better with infarct size and prognosis, then
>this timing may not always hit the peak level. From my
>limited experience of measuring TnI in acute MI
>patients admitted to our CCU, it is usually cardiac
>enzyme 2 or 3 which show the peak TnI level coinciding
>with peak CK levels (NB: in our Hospital CCU, CK and
>AST are measured at 8hrly intervals). Therefore 16-18
>hours post admission timing may be more appropriate in
>this regard. Alternatively, we should probably aim at
>getting two troponin results taken 8 hours apart,
>which will give us a slope from which we can estimate
>infarct size. Also having a second sample for troponin
>will provide a saftey net should any thing goes wrong
>analytically or otherwise with the first sample. The
>cost of course will double. Your expert opinion on
>this matter is greatly appreciated.
>
>=====
>Dr. M A Al-Jubouri
>Consultant Chemical Pathologist
>Whiston Hospital
>Prescot
>Merseyside L35 5DR
>UK
>
>__________________________________________________
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I am not aware of data for peak I vs infarct size. We found the 12-24 hours
sample optimunn (and practical) to predict ejection fraction
--
Paul Collinson
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