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Dear Michael

I am sorry of not making clear that we are intending
to change to single TnI measurement. For a period of
time we are running the classical enzymes with TnI for
a learning curve to be established. It is through this
that my queries regarding timing came to light.

--- "Vince, Michael" <[log in to unmask]>
wrote: >  
> 
> Dr. Al-Jubouri :
> My preference is to take two blood specimens, one
> immediately after
> admission and a second after an additional 6 - 8
> hours.  I recognize that in
> most cases you won't be hitting the peak value for
> the cTnI, but as you
> indicated the slope may give an approximation of
> infarct size.   As far as
> the extra cost of doing two cTnIs rather than one,
> have you considered NOT
> doing CK and AST (and CKMB?)?  At the risk of
> displaying my undoubted
> ignorance, I'm not at all sure what additional
> information one gets by doing
> CK and AST in addition to cTnI.
> Our ER physicians would not be at all pleased if we
> implemented a protocol
> with a single cTnI timed for the peak value - they
> insist on a protocol
> which allows them to rule in/out AMI / ACS (in those
> patients with equivocal
> ECGs) as fast as possible, certainly in less than 12
> hours, and preferably
> as soon as the patient comes through the hospital
> doors!
> 
> Hope this is of help.
> 
> 
>  
> 


=====
Dr. M A Al-Jubouri
Consultant Chemical Pathologist
Whiston Hospital
Prescot
Merseyside L35 5DR
UK

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