Authors

Guohua Zhao, Yutong Zhao, Hu Zhang#

Departments

Department of Emergency, People's Hospital of Jizhou District, Tianjin, PR China

Abstract

Objective: To investigate the value of the duration of chest pain, troponin levels, and D-dimer levels in differentiating patients with acute high-risk chest pain (acute myocardial infarction, aortic dissection, and pulmonary embolism).

Methods: A total of 309 patients with high-risk chest pain visiting our emergency department from January 2017 to December 2019 were enrolled in the study. Of these, 268 patients got acute myocardial infarction, 22 patients got aortic dissection, and 19 patients got pulmonary embolism. The duration of chest pain and the levels of D-dimer and cardiac troponin (CTNI) were recorded.

Results: The duration of chest pain was much longer in the pulmonary embolism group than in the acute myocardial infarction group or the aortic dissection group (P<.05). The troponin levels were much higher in the acute myocardial infarction group than in those in the aortic dissection group and the pulmonary embolism group (P<.001). However, there was no statistical significance in troponin levels between the aortic dissection group and the pulmonary embolism group (P>.05). The D-dimer levels were much higher in the aortic dissection group and pulmonary embolism group than in the acute myocardial infarction group (P<.001), but there was no statistical significance in D-dimer levels between the two former groups (P>.05). At a baseline of 0.5 mg/L, the sensitivity and specificity of D-dimer levels for differentiating aortic dissection and myocardial infarction were 80.52% and 78.57%, respectively. A ROC curve analysis showed the ideal value of D-dimer to balance sensitivity and specificity was 0.7 mg/L.

Conclusions: Focusing on the attack time of patients with high-risk chest pain and rapidly detecting their troponin and D-dimer levels are beneficial for diagnosing high-risk chest pain and differentiate its causes.

Keywords

Chest pain time, troponin, D dimer, high-risk chest pain.

DOI:

10.19193/0393-6384_2020_3_248