Brief Report Implication of cardiac marker elevation in patients who resuscitated from out-of-hospital cardiac arrest ☆ Sang Hoon Oh MD, Young Min Kim MD, PhD, Han Joon Kim MD, PhD, Chun Song Youn MD, Seung Pill Choi MD, PhD, Jung Hee Wee MD, Soo Hyun Kim MD, Won Jung Jeong MD, Kyu Nam Park MD, PhD ⁎ Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul 137-701, South Korea Received 14 November 2010; accepted 15 December 2010 Abstract Objectives: It is often difficult to diagnose acute myocardial infarction (AMI) in patients who resuscitated after out-of-hospital cardiac arrest (OHCA) and had a delayed elevation in cardiac marker. This study explored whether elevations in cardiac marker were due to coronary artery occlusion or resulted from other causes. Methods: The study included 19 non–ST-segment elevation patients who resuscitated after OHCA and underwent delayed coronary angiography. We checked patients' serial creatine kinase–myocardial band (CK-MB) and troponin I (cTnI) levels on arrival and 6, 12, 24, 48, 72, and 96 hours postarrest. Based on the association of elevated cTnI and the results of their delayed angiographies, the patients were retrospectively divided into 2 groups: an AMI group (n = 5) and a non-AMI group (n = 14). We then analyzed the serial cardiac marker measurements in each group. Results: Peak marker levels were significantly higher in the AMI group than in the non-AMI group (CK-MB, 177.0 ± 112.7 vs 66.4 ± 85.2 ng/mL; P = .033 and cTnI, 40.4 ± 14.5 vs 10.6 ± 13.5 ng/mL; P = .005). After adjusting for covariates, the peak and 6-, 12-, and 24-hour cTnI and 6-hour CK-MB were significantly different between the 2 groups (P = .005, P = .004, P = .005, P = .020, and P = .007). In the non-AMI group, 3 patients had cTnI values that were within the reference range at all of the evaluated times. Most patients had only low cTnI elevations that rapidly fell back to normal. Conclusion: The resuscitation of patients who experience sudden OHCA but do not have an AMI may lead to elevations of cardiac markers. However, these elevations are low and normalize early. © 2012 Elsevier Inc. All rights reserved. 1. Introduction When patients experience sudden out-of-hospital cardiac arrest (OHCA) and are successfully resuscitated, differenti- ating acute myocardial infarction (AMI) from other causes is especially important in guiding postresuscitation manage- ment strategies such as immediate percutaneous coronary intervention (PCI) and implantable cardioverter-defibrillator; these strategies can improve patients' clinical outcomes [1-6]. The new universal definition of myocardial infarction ☆ Conflict of interest: The authors declare that they have no competing interests. ⁎ Corresponding author. Department of Emergency Medicine, Seoul St Mary's Hospital, Seocho-Gu, Seoul 137-701, South Korea. Tel.: +82 2 2258 1987; fax: +82 2 2258 1997. E-mail address: emsky@catholic.ac.kr (K. Nam Park). www.elsevier.com/locate/ajem 0735-6757/$ – see front matter © 2012 Elsevier Inc. All rights reserved. doi:10.1016/j.ajem.2010.12.022 American Journal of Emergency Medicine (2012) 30, 464–471