Cardiac Enzymes Over Time
|Type||Interval (hours)||Peak Elevation (hours)||Return to Normal|
|Troponin I||3-12||10-24||3-10 days|
|Troponin T||3-12||10-24||5-14 days|
- Can be elevated in trauma, rhabdomyolysis, hyperthermia, physical activity, renal or endocrine disease, systemic infections
- If patient 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
- CK-MB can be removed from the routine ED cardiac panel without adversely affecting patient care
- Le RD, Kosowsky JM, Landman AB, et al. Clinical and financial impact of removing creatine kinase-MB from the routine testing menu in the emergency setting. Am J Emerg Med. 2015;33(1):72–5.