What is the role of a basic metabolic panel in the workup of acute coronary syndrome (ACS)?

Updated: Sep 30, 2020
  • Author: David L Coven, MD, PhD; Chief Editor: Eric H Yang, MD  more...
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Obtain a basic metabolic profile, including a check of blood glucose level, renal function, and electrolytes levels, for patients with new-onset angina. Close monitoring of potassium and magnesium levels is important in patients with ACS because low levels may predispose them to ventricular arrhythmias. Routine measurement of serum potassium levels and prompt correction are recommended.

Creatinine levels must be considered before using an angiotensin-converting enzyme (ACE) inhibitor and particularly if cardiac catheterization is considered. Use of N -acetylcysteine and adequate hydration can help prevent contrast material–induced nephropathy. [36]

Other useful metabolic profiles include amylase and lipase.

A study by Charpentier et al suggests that a serum glucose level of more than 140 mg/dL is associated with non-ST elevation ACS in patients admitted to an ED for chest pain. However, when this level of blood glucose is added to the conventional diagnostic tools, the result is only a small increase in the ability to classify ACS. [37]

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