For Primary PCI to be most effective . . . Do it before the Troponin appear in blood !
Posted Mar 09 2011 12:38pm
Is there a bio chemical way to measure time window in STEMI ?
It seems so. In this era of hyperacute PCIs , we are supposed to diagnose STEMI very early .If you wait for troponin to assit you in diagnosis it implies one has missed the golden hour already (At least Three golden hours to be precise !)
Cardiac enzymes have a unique value in timing a STEMI as time of onset of chest pain is unrealiable
as the patient (Even the physician !) may not be able to differentiate pre infarction angina from infarct pain.
In these situation cardiac enzymes provide us a clue.
The time of realse of these molecules are fairly predictable.
Myoglobin -2 -3hours
Troponin elvation -3 -6 hours
CPK - 8 -12hours
Remember ECG rarely show a time lag in diagnosing STEMI !
For maximum benefit . . . try to perform the primary PCI before the troponin appear in blood .
Does this sound a crazy tip ? What to do . . . truths are very often crazy .