Because it has increased specificity compared with ck mb troponin is composed of 3 proteins troponin c cardic troponin i and cardiac troponin t. Profiles of total ck ck mb and troponin i in acute myocardial infarction ami discussion the diagnosis of ami is usually predicated on the who criteria of chest pain ecg changes and increases in biochemical markers of myocardial injury.
1998 nov 19 suppl n n16 24.
Troponin vs ck mb graph. Ck mb levels increase in the serum 4 9 hours after chest pain begins reach peak values within 24 hours and return to baseline values within 48 72 hours. Troponin test the most sensitive and specific test for myocardial damage. With the implementation of troponin ck and ck mb have minimal value but they can be used in certain instances.
Serial ck mb levels commonly are obtained at admission to the emergency department and are repeated in 6 12 hours. The following are key points to remember about eliminating creatine kinase myocardial band ck mb testing in suspected acute coronary syndrome acs. Troponin i especially has a high affinity for myocardial injury.
These instances are typically after heart instrumentation cabg or pci or to detect a second mi since troponins have such a long half life and do not return to baseline levels until 1 2 weeks after the initial incident. Advancements led to the development of isoenzymes of ck and ldh ck mb and ldh 1 2 2. Cardiac biomarker testing occurs in nearly 30 million emergency department visits nationwide each year in the united states.
8 ck mb is not sensitive enough for diagnosis within 4 hours from the time of symptom onset but test sensitivity rises 6 hours or more after the onset. Ck mb may be used in follow up to an elevated ck and or when the troponin test is not available. Troponin t or troponin i or ck mb or none eur heart j.
Cardiac markers are used in the diagnosis and risk stratification of patients with chest pain and suspected acute coronary syndrome acs. Cpk mb vs troponin i better marker for acute myocardium infarction vivek kumar garg demonstrator government medical college and hospital india abstract acute myocardial infarction ami occurs when blood flow is. Author p o collinson 1 affiliation 1 department of chemical pathology mayday university hospital thornton heath surrey uk.
The cardiac troponins in particular have become the cardiac markers of choice.