TROPONIN BASED RULE-IN AND RULE-OUT ALGORITHM OF MYOCARDIAL INFARCTION
First Claim
1. A method for diagnosing myocardial infarction in a subject presenting with chest pain, comprising the steps of:
- a) determining the amount of a cardiac troponin in a first sample from the subject obtained at presentation to a physician, andb) determining the amount of a cardiac troponin in a second sample from said subject obtained within one hour after the first sample,(A) wherein the subject does not suffer from myocardial infarction,(i) if the subject is 75 years old or older and the amount of the cardiac troponin in the second sample is less than 25 ng/l, or(ii) if the subject is younger than 75 years and the amount of the cardiac troponin in the first sample is less than 12 ng/l, and if the difference between the amount of the cardiac troponin in the second sample and the amount in first sample is less than 3 ng/l,(B) wherein the subject suffers from myocardial infarction,(i) if the amount of the cardiac troponin in the first sample is less than 12 ng/l and if the difference between the amount of the cardiac troponin in the second sample and the amount in the first sample is at least 15 ng/l,(ii) if the amount of the cardiac troponin in the first sample is larger than or equal to 12 ng/l and less than 60 ng/l and if the difference between amount of the cardiac troponin in the second sample and the amount of the cardiac troponin in the first sample is at least 15 ng/l, or(iii) if the amount of the cardiac troponin in the first sample is at least 60 ng/l.
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Abstract
The present invention relates to a method for diagnosing myocardial infarction in a subject presenting with chest pain. The method is based on the determination of an amount of a cardiac troponin in a first sample from the subject obtained at presentation to a physician, and in a second sample obtained within one hour after the first sample. Moreover, the present invention envisages a method for ruling in myocardial infarction and a method for ruling out myocardial infarction. The said methods are also based on the determination of the amount of a cardiac troponin in a first sample from the subject obtained at presentation to a physician, and in a second sample obtained within one hour after the first sample.
52 Citations
24 Claims
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1. A method for diagnosing myocardial infarction in a subject presenting with chest pain, comprising the steps of:
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a) determining the amount of a cardiac troponin in a first sample from the subject obtained at presentation to a physician, and b) determining the amount of a cardiac troponin in a second sample from said subject obtained within one hour after the first sample, (A) wherein the subject does not suffer from myocardial infarction, (i) if the subject is 75 years old or older and the amount of the cardiac troponin in the second sample is less than 25 ng/l, or (ii) if the subject is younger than 75 years and the amount of the cardiac troponin in the first sample is less than 12 ng/l, and if the difference between the amount of the cardiac troponin in the second sample and the amount in first sample is less than 3 ng/l, (B) wherein the subject suffers from myocardial infarction, (i) if the amount of the cardiac troponin in the first sample is less than 12 ng/l and if the difference between the amount of the cardiac troponin in the second sample and the amount in the first sample is at least 15 ng/l, (ii) if the amount of the cardiac troponin in the first sample is larger than or equal to 12 ng/l and less than 60 ng/l and if the difference between amount of the cardiac troponin in the second sample and the amount of the cardiac troponin in the first sample is at least 15 ng/l, or (iii) if the amount of the cardiac troponin in the first sample is at least 60 ng/l. - View Dependent Claims (2, 3, 6, 9, 12, 15, 18, 21, 24)
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4. A method for ruling-out myocardial infarction in a subject presenting with chest pain, comprising the steps of:
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a) determining the amount of a cardiac troponin in a first sample from the subject obtained at presentation to a physician, and b) determining the amount of a cardiac troponin in a second sample from said subject obtained within one hour after the first sample, wherein myocardial infarction can be ruled-out in the subject, (i) if the subject is 75 years old or older, and if the amount of the cardiac troponin in the second sample is less than 25 ng/l, or (ii) if the subject is younger than 75 years and the amount of the cardiac troponin in the first sample is less than 12 ng/l, and if the difference between the amount of the cardiac troponin in the second sample and the amount in first sample is less than 3 ng/l. - View Dependent Claims (7, 10, 13, 16, 19, 22)
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5. A method for ruling-in myocardial infarction in a subject presenting with chest pain, comprising the steps of:
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a) determining the amount of a cardiac troponin in a first sample from the subject obtained at presentation to a physician, and b) determining the amount of a cardiac troponin in a second sample from said subject obtained within one hour after the first sample, wherein myocardial infarction can be ruled-in in the subject, (i) if the amount of the cardiac troponin in the first sample is less than 12 ng/l and if the difference between the amount of the cardiac troponin in the second sample and the amount in the first sample is at least 15 ng/l, (ii) if the amount of the cardiac troponin in the first sample is larger than or equal to 12 ng/l and less than 60 ng/l and if the difference between amount of the cardiac troponin in the second sample and the amount of the cardiac troponin in the first sample is at least 15 ng/l, or (iii) if the amount of the cardiac troponin in the first sample is at least 60 ng/l. - View Dependent Claims (8, 11, 14, 17, 20, 23)
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Specification