Analysis of CK-MB and cTnI accordance measured on admission in non-ST segment elevation acute coronary syndrome patients

Objective:We sought to evaluate the association between discordant cardiac marker results of CK-MB and cTnI on early risk stratification in patients with Non-ST Segment Elevation Acute Coronary Syndrome(NSTE-ACS).Method:The total of 1 074 NSTE-ACS patients were admitted and whose CK-MB and cTnI were measured within the first 36 hours from symptom onset after admission.All patients received coronary angiography within 48 h.Positive results were accepted if biomarker 1×upper limit of normal(ULN),and negative results was accepted when biomarker ≤1×ULN.We examined relationships between results of four different combinations(CK-MB-/cTnI-,CK-MB+/cTnI-,CK-MB-/cTnI+,and CK-MB+/cTnI+) and incidences of in-hospital Major Adverse Cardiac Event(MACE) and early catheter-based interventions.Result:Among 1 074 NSTE-ACS patients,results from 930 patients were accordant in CK-MB and cTnI level,and the other 144 were discordant(n=90 CK-MB+/cTnI-;n=54 CK-MB-/cTnI+).The number and types of diseased coronary artery and the incidence of MACE did not have statistical difference between the CK-MB-/cTnI+ and CK-MB+/cTnI-group.Conclusion:Elevation of cTnI alone can predict a higher risk of NSTE-ACS patients in hospital.Prognostic value of isolated CK-MB+ is equal to isolated cTnI when the tests performed early after admission(36 h).