Cardiac enzymes
Markers
Name | INTL | ELV PEAK | RETRN |
myglbn | 1-4h | 6-7h | 18-24h |
trp I | 3-12 | 10-24 | 3-10d |
trp T | 3-12 | 10-24 | 5-14d |
ckmb | 4-12 | 12-24 | 48-72 |
ldh | 8-12 | 24-48 | 10-14d |
- n I - 2-4 hrs 1st detect
- 8-12 hrs w/100% sensitivity
- 10-24 peak
- 5-10 day duration
- Tn T - above plus 5-14 d duration
- CK-MB : 3-4
- 8-12 (100% sensitive)
- 10-24 hr peak
- MYOGLOBIN : 1-2 hrs detect first
- 4-8 100% sens
- 4-8 peak
- 0.5-1.0 duration
- 2-4 day duration
Creatine Phosphokinase
-can be elevated in trauma, rhabdo, hyperthermia, physical activity, renal or endocrine dz, systemic infections
-if pt small with small muscle mass to begin with, total ck may not be elevated- so better to use ck index- is ratio of ckmb/ total ck. Elevated if > 3- 5%.
-CK Mass: with monoclonal antibody techniques, can directly measure ck mb mass as mmcg/L. More sensitive for detection of ami
Troponins
-during contraction of muscle- thick filaments of myosin slide past thin filaments of actin by calcium mediated atp dependent contraction. Released calcium binds to troponin C, T, and I, which regulate muscle contraction.
-troponins not change in trauma, skeletal muscle dz, exercise, renal failure like ck does.
-troponin C found in all tissue and is not cardiac marker
-troponin T is qualitative assay.
-troponin I is quantitative assay.
See Also
Cards: CK-MB
Cards: Troponin