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Definition of acute coronary syndrome
  1. I N Findlay1,
  2. A D Cunningham2
  1. 1Royal Alexandra Hospital, Paisley, UK
  2. 2National Clinical Audit Support Programme, NHS Information Authority, Tavistock House, London, UK
  1. Correspondence to:
    Dr Iain N Findlay
    Royal Alexandra Hospital, Corsebar Road, Paisley, PA2 9PN, UK;

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The British Cardiac Society (BCS) Working Group on the definition of acute myocardial infarction1 presents a pragmatic and practical nomenclature for acute coronary syndromes (ACS) and sets definite cut off points for troponin T (TnT) and troponin I (TnI).

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 …

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    BMJ Publishing Group Ltd and British Cardiovascular Society