Definition of acute coronary syndrome

Abstract

We reviewed retrospectively the relation between TnT and creatine kinase (CK) in 978 admissions to our cardiac care unit (over a three year period) who survived to discharge. Criteria for inclusion were simple—that the final discharge diagnosis be recorded, and that patients survive to discharge and had TnT and a peak CK recorded. No attempt was made to correct for sampling time. Our aim was to establish a cut off value for TnT to be equivalent to twice our upper limit of normal for CK (2 × 190 = 380 IU). The mean TnT was 1.09 ng/ml and the mean CK was 433 IU. The correlation between the two, while significant, was not good enough to be clinically useful (fig 1). CK could range from 200–1000 IU for a TnT of 1 ng/ml. A TnT of 0.75 ng/ml was the best analogue of a CK of 380 IU.