Can we monitor heart attack in the troponin era: evidence from a population-based cohort study

Table 4 Hierarchical diagnosis and classification of myocardial infarction based on AHA Criteria using only CK biomarkers

Year	HMDC episodes of care		AHA classification of MI^an (row%, col%)
	Hierarchical diagnosis	Count	Positive MI	Any MI	Not MI
1998	MI	1420	816 (57.5, 89.4)	999 (70.4, 88.5)	421 (29.6, 17.6)
	Unstable angina	2011	89 (4.4, 9.8)	115 (5.7, 10.2)	1896 (94.3, 79.2)
	Other IHD^b	22	4 (18.2, 0.4)	4 (18.2, 0.3)	18 (81.8, 0.8)
	Other CVD^b	69	4 (5.8, 0.4)	11 (15.9, 1.0)	58 (84.1, 2.4)
	Total	3522	913	1129	2393
2003	MI	1579	752 (47.6, 88.2)	962 (60.9, 87.1)	617 (39.1, 28.1)
	Unstable angina	1493	67 (4.5, 7.8)	99 (6.6, 9.0)	1394 (93.4, 63.6)
	Other IHD^b	48	11 (22.9, 1.3)	13 (27.1, 1.2)	35 (72.9, 1.6)
	Other CVD^b	177	23 (13.0, 2.7)	30 (17.0, 2.7)	147 (83.0, 6.7)
	Total	3297	853	1104	2193

For non-fatal population estimates in 1998 and 2003 using only CK or CK-MB biomarker results. AHA: American Heart Association; CK: creatinine kinase; CK-MB: MB isoenzyme of CK; CVD: cardiovascular disease; HMDC: Hospital Morbidity Data Collection; MI: myocardial infarction; MI-HMDC: MI coded in the HMDC; Positive MI: AHA Definite or Probable MI; Any MI: AHA Definite/Probable/Possible MI; IHD: ischaemic heart disease.
^a Luepker et al [12]. Row% represents positive predictive value, col% represents sensitivity.
^b As listed in Table 1 (Other CVD includes chest pain).

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