The
National Academy of Clinical Biochemistry
Laboratory Medicine Practice Guidelines
Published
Guidelines
RECOMMENDATIONS
FOR THE USE OF
CARDIAC MARKERS IN CORONARY ARTERY DISEASES
Alan H.B. Wu, Fred S. Apple, W. Brian Gibler, Robert L. Jesse,
Myron M. Warshaw, and Roland Valdes, Jr.
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The
Sixth Conference on the "Standards of Laboratory Practice Series" sponsored
by the National Academy of Clinical Biochemistry (NACB), was held on August
4-5, 1998, at the Annual Meeting of the American Association for Clinical
Chemistry, in Chicago, IL. An expert committee was assembled to write
recommendations on the use of cardiac markers in coronary artery diseases.
The NACB Committee prepared a preliminary draft of the guidelines, made
them available on the World Wide Web (www.nacb.org), and distributed them
before the presentations. The recommendations were divided into four areas:
the use of markers in the triage of patients with chest pain, acute coronary
syndromes, clinical applications other than acute myocardial infarction
and research, and assay platforms and markers of acute myocardial infarction.
The recommendations were revised and subsequently re-presented in part
at the "Biomarkers in Acute Cardiac Syndromes Conference", sponsored by
the Jewish Hospital Heart and Lung Institute, Louisville KY, on October
16-17, 1998. This report lists each recommendation, its scientific justification,
and a summary of discussions from conference participants and reviewers.
The majority of this work has been published in Clinical Chemistry 1999;45:1104-1121.
Approximately 100 individuals responded to various versions of these recommendations
via direct correspondences, telephone calls to Committee members, electronic
mail correspondence to the Committee Chairman, or oral questions and comments
raised during one of the two conference presentations. Some of the recommendations
were changed to reflect the consensus opinion. In cases in which there
was no consensus, the Committee included pertinent discussion without
necessarily changing the original recommendations. At times, the Committee
members felt that although a particular recommendation might not be the
current standard of care today, they anticipate that it likely will be
adopted in the near future.
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